MEDICARE: OAK HILL CLINIC CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician		WV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336148931
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OAK HILL CLINIC CORP

Provider Business Mailing Address
First Line	:	PO BOX 848409
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02284-8409
Country	:	US
Telephone Number	:	877-848-1457
Fax Number	:

Provider Business Practice Location Address
First Line	:	320 JONES AVE
Second Line	:
City	:	OAK HILL
State	:	WV
Zip	:	25901-2909
Country	:	US
Telephone Number	:	304-469-2500
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF PROVIDER ENROLLMENT
Name	:	DEBBIE BREWER
Credential	:
Telephone Number	:	877-892-9813

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	07/21/2022

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Directions to “OAK HILL CLINIC CORP ” Practice Location

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