Healthcare Provider Details

I. General information

NPI: 1396808879
Provider Name (Legal Business Name): OXFORD ENDOCRINOLOGY CONSULTANTS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 01/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

512 AZALEA DRIVE
OXFORD MS
38655
US

IV. Provider business mailing address

512 AZALEA DRIVE
OXFORD MS
38655
US

V. Phone/Fax

Practice location:
  • Phone: 662-236-2923
  • Fax: 662-236-4563
Mailing address:
  • Phone: 662-236-2923
  • Fax: 662-236-4563

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number18903
License Number StateMS

VIII. Authorized Official

Name: LORIE A CHANDLER
Title or Position: BILLING MANAGER
Credential:
Phone: 662-236-2923