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General NPI Number Information
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NPI Number | 1548551500
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Entity Type | Organization
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Legal Business Name | MICHAEL S OAKLEY MD PC
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Dates
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Enumeration Date | 04/26/2011
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Last Update Date | 06/15/2011
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Provider Practice Location Address
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Address Line | 60 N MAIN ST
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City | SOUTHAMPTON
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State | NY
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Zip | 11968-3336
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Country | US
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Telephone | 631-204-1361
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Fax | 631-204-1367
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Provider Business Mailing Address
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Address Line | 60 N MAIN ST
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City | SOUTHAMPTON
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State | NY
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Zip | 11968-3336
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Country | US
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Telephone | 631-204-1361
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Fax | 631-204-1367
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MICHAEL SCOTT OAKLEY
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Credential | M.D.
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Telephone | 631-204-1361
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 183363
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License Number State | NY
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