Healthcare Provider Details

I. General information

NPI: 1649436395
Provider Name (Legal Business Name): OXFORD SURGICAL AND BARIATRIC CLINIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2008
Last Update Date: 02/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 AZALEA DR
OXFORD MS
38655-8100
US

IV. Provider business mailing address

PO BOX 590
OXFORD MS
38655-0590
US

V. Phone/Fax

Practice location:
  • Phone: 662-234-4744
  • Fax: 662-234-4749
Mailing address:
  • Phone: 662-234-4744
  • Fax: 662-234-4749

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: RICHARD WALKER BYARS
Title or Position: SOLE MEMBER
Credential: M.D.
Phone: 662-234-4744