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General NPI Number Information
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NPI Number | 1508914102
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Entity Type | Organization
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Legal Business Name | OXFORD LUNG PHYSICIANS, P.A.
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 09/05/2007
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Provider Practice Location Address
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Address Line | 2301 S LAMAR BLVD STE 100 2301 S LAMAR BLVD STE 100
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City | OXFORD
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State | MS
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Zip | 38655-5373
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Country | US
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Telephone | 662-234-0119
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Fax | 662-234-0090
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Provider Business Mailing Address
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Address Line | PO BOX 768 2301 S LAMAR BLVD. STE 100
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City | OXFORD
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State | MS
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Zip | 38655-0768
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Country | US
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Telephone | 662-234-0119
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Fax | 662-234-0090
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Authorized Official
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Title or Position | PRESIDENT OWNER
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Name | DR. JEFFREY N EVANS
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Credential |
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Telephone | 662-234-0119
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 12109,17162,R862053
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License Number State | MS
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