| Ottawa University | |
| 
					15950 N. Civ Center Plaza Surprize AZ 85374  | |
| (972) 367-4845 | |
| Not Available | 
| Full Name | Ottawa University | 
|---|---|
| Speciality | General Practice | 
| Location | 15950 N. Civ Center Plaza, Surprize, Arizona | 
| Authorized Official Name and Position | Mouzon Bass (AGENT) | 
| Authorized Official Contact | 9723674845 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Ottawa University 5050 Spring Valley Rd Dallas TX 75244-3995 Ph: () -  | Ottawa University 15950 N. Civ Center Plaza Surprize AZ 85374 Ph: (972) 367-4845  | 
| NPI Number | 1346751351 | 
|---|---|
| Provider Enumeration Date | 10/17/2017 | 
| Last Update Date | 10/17/2017 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1346751351 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 208D00000X | General Practice | 31375 (Arizona) | Primary |