Healthcare Provider Details

I. General information

NPI: 1154483444
Provider Name (Legal Business Name): OXFORD INTERNAL MEDICINE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 04/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 W CHURCH ST
OXFORD OH
45056
US

IV. Provider business mailing address

12 W CHURCH ST
OXFORD OH
45056
US

V. Phone/Fax

Practice location:
  • Phone: 513-523-4195
  • Fax: 513-523-4353
Mailing address:
  • Phone: 513-523-4195
  • Fax: 513-523-4353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. SHARON L BOWLING
Title or Position: OFFICE MANAGER
Credential:
Phone: 513-523-4195