Healthcare Provider Details

I. General information

NPI: 1679107825
Provider Name (Legal Business Name): OCH HUXFORD CLINIC PULMONOLOGY SLEEP MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2020
Last Update Date: 02/28/2025
Certification Date: 02/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 HOSPITAL RD
STARKVILLE MS
39759-2155
US

IV. Provider business mailing address

PO BOX 1506
STARKVILLE MS
39760-1506
US

V. Phone/Fax

Practice location:
  • Phone: 662-615-3721
  • Fax: 662-615-3728
Mailing address:
  • Phone: 662-615-2504
  • Fax: 662-615-2554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: SUSAN H. RUSSELL
Title or Position: CFO
Credential:
Phone: 662-615-2550