Healthcare Provider Details

I. General information

NPI: 1083690382
Provider Name (Legal Business Name): JAMES MICHAEL OAKS DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2005
Last Update Date: 04/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 MESSIMER DRIVE
NEWARK OH
43055
US

IV. Provider business mailing address

455 RILEY AVE
WORTHINGTON OH
43085-3038
US

V. Phone/Fax

Practice location:
  • Phone: 740-348-4870
  • Fax: 740-348-4871
Mailing address:
  • Phone: 740-348-4870
  • Fax: 740-348-4871

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084F0202X
TaxonomyForensic Psychiatry Physician
License Number34.007130
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number34007130
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: