Healthcare Provider Details

I. General information

NPI: 1922379742
Provider Name (Legal Business Name): OXFORD ANESTHESIA SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2012
Last Update Date: 05/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 S SAGINAW ST SUITE 1815
FLINT MI
48507-2677
US

IV. Provider business mailing address

1451 CEDARWOOD DR
FLUSHING MI
48433-1875
US

V. Phone/Fax

Practice location:
  • Phone: 810-732-8336
  • Fax:
Mailing address:
  • Phone: 810-659-7592
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number4704135765
License Number StateMI

VIII. Authorized Official

Name: DEBORAH S OXFORD
Title or Position: SOLE MBR
Credential:
Phone: 810-659-7592