Healthcare Provider Details

I. General information

NPI: 1508999871
Provider Name (Legal Business Name): OXFORD CLINIC FOR WOMEN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 07/21/2022
Certification Date: 04/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2610 S. LAMAR BLVD
OXFORD MS
38655-5243
US

IV. Provider business mailing address

2610 S. LAMAR BLVD
OXFORD MS
38655-5243
US

V. Phone/Fax

Practice location:
  • Phone: 662-234-1731
  • Fax: 662-236-2392
Mailing address:
  • Phone: 662-234-1731
  • Fax: 662-236-2392

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateMS

VIII. Authorized Official

Name: RONALD BLAKE SMITH
Title or Position: OWNER
Credential: MD
Phone: 662-234-1731