Healthcare Provider Details

I. General information

NPI: 1992911366
Provider Name (Legal Business Name): OXFORD MEDICAL IMAGING P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 04/29/2022
Certification Date: 04/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 OXFORD RD
NEW HARTFORD NY
13413-2651
US

IV. Provider business mailing address

1 OXFORD RD
NEW HARTFORD NY
13413-2651
US

V. Phone/Fax

Practice location:
  • Phone: 315-738-1795
  • Fax: 315-738-1798
Mailing address:
  • Phone: 315-738-1795
  • Fax: 315-738-1798

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN M MCKENNAN
Title or Position: MD / OWNER
Credential: MD
Phone: 315-738-1795