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General NPI Number Information
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NPI Number | 1538214143
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Entity Type | Organization
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Legal Business Name | OXFORD PHYSICAL MEDICINE & REHABILITATION PLLC
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 01/02/2009
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Provider Practice Location Address
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Address Line | 705 N LAMAR BLVD
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City | OXFORD
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State | MS
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Zip | 38655-3242
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Country | US
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Telephone | 662-236-7070
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Fax | 662-236-7078
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Provider Business Mailing Address
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Address Line | 705 N LAMAR BLVD
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City | OXFORD
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State | MS
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Zip | 38655-3242
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Country | US
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Telephone | 662-236-7070
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Fax | 662-236-7078
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | JOHN R TAIT
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Credential | M.D.
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Telephone | 662-236-7070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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