Healthcare Provider Details

I. General information

NPI: 1013073402
Provider Name (Legal Business Name): OAKWOOD GROUP IX
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26650 EUREKA RD SUITE C
TAYLOR MI
48180-4835
US

IV. Provider business mailing address

26650 EUREKA RD SUITE C
TAYLOR MI
48180-4835
US

V. Phone/Fax

Practice location:
  • Phone: 734-941-0573
  • Fax: 734-941-1101
Mailing address:
  • Phone: 734-941-0573
  • Fax: 734-941-1101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: MR. DAVID A IPPEL
Title or Position: DIVISION PRESIDENT
Credential:
Phone: 734-266-2780