Healthcare Provider Details

I. General information

NPI: 1972894293
Provider Name (Legal Business Name): OXFORD CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2011
Last Update Date: 04/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1713 HAMRIC DR E
OXFORD AL
36203-2015
US

IV. Provider business mailing address

7500 HUGH DANIEL DR SUITE 150
BIRMINGHAM AL
35242-7148
US

V. Phone/Fax

Practice location:
  • Phone: 205-408-2777
  • Fax:
Mailing address:
  • Phone: 205-408-2777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. DAVID GRAY
Title or Position: DIRECTOR
Credential:
Phone: 205-408-2777