WESTERN KENTUCKY UNIVERSITY SPORTS MEDICINE; NPI #1790075273

Contact Information

WESTERN KENTUCKY UNIVERSITY SPORTS MEDICINE

1605 AVENUE OF CHAMPIONS
RM 128
BOWLING GREEN, KY 42101-6412

Phone: 972-687-1877
Fax: 972-367-3434
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Student Health	261QS1000X

Indicates primary specialty

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NPI Profile & details for WESTERN KENTUCKY UNIVERSITY SPORTS MEDICINE

NPI Number	`1790075273`
LBN Legal business name	WESTERN KENTUCKY UNIVERSITY SPORTS MEDICINE
Authorized official	BILL EDWARDS - (DIRECTOR OF SPORTS MEDICINE)
Entity	Organization
Organization subpart ¹	No
Enumeration date	04/18/2011
Last updated	04/18/2011 - About 15 years ago
Identifiers	n/a

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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