Healthcare Provider Details
I. General information
NPI: 1356437867
Provider Name (Legal Business Name): OXFORD PEDIATRICS & ADOLESCENTS INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/04/2006
Last Update Date: 07/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5141 MORNING SUN RD
OXFORD OH
45056
US
IV. Provider business mailing address
5141 MORNING SUN RD
OXFORD OH
45056
US
V. Phone/Fax
- Phone: 513-523-2156
- Fax: 513-523-2503
- Phone: 513-523-2156
- Fax: 513-523-2503
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
JAMES
B
DAVIS
Title or Position: OWNER
Credential: MD
Phone: 513-523-2156