Healthcare Provider Details

I. General information

NPI: 1376528539
Provider Name (Legal Business Name): DAVID EARL OXFORD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 12/10/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 E MONROE ST
MEXICO MO
65265-2919
US

IV. Provider business mailing address

801 W HIGH POINT LN
COLUMBIA MO
65203-8939
US

V. Phone/Fax

Practice location:
  • Phone: 573-582-5000
  • Fax:
Mailing address:
  • Phone: 573-445-6603
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License NumberR5D02
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: