Healthcare Provider Details

I. General information

NPI: 1851486427
Provider Name (Legal Business Name): OXFORD NEUROMUSCULAR ASSOCIATES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 10/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2908 SOUTH LAMAR BLVD. SUITE 100
OXFORD MS
38655
US

IV. Provider business mailing address

2908 SOUTH LAMAR BLVD SUITE 100
OXFORD MS
38655
US

V. Phone/Fax

Practice location:
  • Phone: 662-281-0112
  • Fax: 662-281-0943
Mailing address:
  • Phone: 662-281-0112
  • Fax: 662-281-0943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number18354
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number StateMS
# 3
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number
License Number StateMS

VIII. Authorized Official

Name: DON HUMFELD
Title or Position: GENERAL MANAGER
Credential:
Phone: 901-606-5239