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1174904239 NPI number — OXFORD VEIN CENTER PLLC

NPI Number: 1174904239
Health Care Provider/Practitioner: OXFORD VEIN CENTER PLLC

Information about “1174904239” NPI (OXFORD VEIN CENTER PLLC) exists in 1174904239 in HTML format HTML  |  1174904239 in plain Text format TXT  |  1174904239 in PDF (Portable Document Format) PDF  |  1174904239 in an XML format XML  formats.

NPI Number : 1174904239 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1174904239",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "OXFORD VEIN CENTER PLLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "300 ENTERPRISE DR",
    "SecondLineMailingAddress": "SUITE B",
    "MailingAddressCityName": "OXFORD",
    "MailingAddressStateName": "MS",
    "MailingAddressPostalCode": "38655-2762",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "662-638-3677",
    "MailingAddressFaxNumber": "662-638-3678",
    "FirstLinePracticeLocationAddress": "300 ENTERPRISE DR",
    "SecondLinePracticeLocationAddress": "SUITE B",
    "PracticeLocationAddressCityName": "OXFORD",
    "PracticeLocationAddressStateName": "MS",
    "PracticeLocationAddressPostalCode": "38655-2762",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "662-638-3677",
    "PracticeLocationAddressFaxNumber": "662-638-3678",
    "EnumerationDate": "06/15/2015",
    "LastUpdateDate": "06/23/2015",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "WALDROP",
    "AuthorizedOfficialFirstName": "CHRISTINE",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "OWNER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "MD",
    "AuthorizedOfficialTelephoneNumber": "662-638-3677",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207L00000X",
          "TaxonomyName": "Anesthesiology Physician",
          "LicenseNumber": "20317",
          "LicenseNumberStateCode": "MS",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "202K00000X",
          "TaxonomyName": "Phlebology Physician",
          "LicenseNumber": "20317",
          "LicenseNumberStateCode": "MS",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        }
      ]
    }
  }
}
                
            

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