National Provider Identifier Database

WESTERN KENTUCKY UNIVERSITY SPORTS MEDICINE
Student Health


Contact Information

WESTERN KENTUCKY UNIVERSITY SPORTS MEDICINE
1605 AVENUE OF CHAMPIONS
RM 128
BOWLING GREEN, KY42101-6412
Phone: 972-687-1877
Fax: 972-367-3434
Website:
Specialty Taxonomy Code
* Student Health 261QS1000X

* Indicates primary specialty

NPI Profile & details for WESTERN KENTUCKY UNIVERSITY SPORTS MEDICINE

NPI Number 1790075273
Legal business name
LBN
WESTERN KENTUCKY UNIVERSITY SPORTS MEDICINE
Authorized official BILL EDWARDS - (DIRECTOR OF SPORTS MEDICINE)
Entity Organization
Organization subpart No
Enumeration date 04/18/2011
Last updated 04/18/2011 - About 15 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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