Healthcare Provider Details

I. General information

NPI: 1578879235
Provider Name (Legal Business Name): OXFORD AFTER HOURS CLINIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2010
Last Update Date: 02/21/2023
Certification Date: 02/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1929 UNIVERSITY AVE
OXFORD MS
38655-4113
US

IV. Provider business mailing address

4520 JAMESTOWN AVE STE 3
BATON ROUGE LA
70808-3214
US

V. Phone/Fax

Practice location:
  • Phone: 662-236-2232
  • Fax: 662-236-2264
Mailing address:
  • Phone: 225-706-3033
  • Fax: 225-218-4888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BRENNAN UTER
Title or Position: CEO
Credential:
Phone: 225-706-3033