MEDICARE: OFS, LLC

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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	MD28533	AL

General Provider Information

NPI Number	:	1497997795
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OFS, LLC

Provider Business Mailing Address
First Line	:	747 N DEAN RD
Second Line	:
City	:	AUBURN
State	:	AL
Zip	:	36830-4027
Country	:	US
Telephone Number	:	334-749-3436
Fax Number	:

Provider Business Practice Location Address
First Line	:	747 N DEAN RD
Second Line	:
City	:	AUBURN
State	:	AL
Zip	:	36830-4027
Country	:	US
Telephone Number	:	334-749-3436
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	THOMAS HUGHES FUQUA JR.
Credential	:	DMD, MD
Telephone Number	:	334-749-3436

Provider Enumeration Date	:	04/01/2009
Last Update Date	:	07/30/2020

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Directions to “OFS, LLC ” Practice Location

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