Healthcare Provider Details

I. General information

NPI: 1972723245
Provider Name (Legal Business Name): OXFORD OPTICAL CO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2007
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20919 GRATIOT AVE
EASTPOINTE MI
48021-2825
US

IV. Provider business mailing address

20919 GRATIOT AVE
EASTPOINTE MI
48021-2825
US

V. Phone/Fax

Practice location:
  • Phone: 586-774-1645
  • Fax:
Mailing address:
  • Phone: 586-774-1645
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT J. FELL
Title or Position: OPTICIAN
Credential:
Phone: 586-774-1645