Healthcare Provider Details

I. General information

NPI: 1750646436
Provider Name (Legal Business Name): OXFORD PRE OP & IMAGING CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2012
Last Update Date: 02/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1202 OFFICE PARK DR SUITE B
OXFORD MS
38655-5267
US

IV. Provider business mailing address

PO BOX 578
OXFORD MS
38655-0578
US

V. Phone/Fax

Practice location:
  • Phone: 662-234-5545
  • Fax: 662-234-5589
Mailing address:
  • Phone: 662-234-5545
  • Fax: 662-234-5589

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number25D2049358
License Number StateMS
# 3
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number36-2-026
License Number StateMS

VIII. Authorized Official

Name: RICHARD WALKER BYARS
Title or Position: SECRETARY
Credential: MD
Phone: 662-234-4744