Healthcare Provider Details

I. General information

NPI: 1336256254
Provider Name (Legal Business Name): THOMAS J OXFORD P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 APRIL AVE
CARMI IL
62821-1577
US

IV. Provider business mailing address

386 COUNTY ROAD 450 N
NORRIS CITY IL
62869-3409
US

V. Phone/Fax

Practice location:
  • Phone: 618-382-3755
  • Fax: 618-382-2377
Mailing address:
  • Phone: 618-378-2048
  • Fax: 618-382-2377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: