Healthcare Provider Details

I. General information

NPI: 1235456336
Provider Name (Legal Business Name): OXFORD OPTICIANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2010
Last Update Date: 04/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 W HIGH ST
OXFORD OH
45056-1710
US

IV. Provider business mailing address

39 W HIGH ST
OXFORD OH
45056-1710
US

V. Phone/Fax

Practice location:
  • Phone: 513-523-6616
  • Fax: 513-523-6616
Mailing address:
  • Phone: 513-523-6616
  • Fax: 513-523-6616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number1228-SC
License Number StateOH

VIII. Authorized Official

Name: MR. THOMAS SCOTT HICKS
Title or Position: PRESIDENT
Credential: L.D.O.
Phone: 513-523-6616