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NPI Code Detail

MEDICARE: JOHN B OXLEY DPT

MEDICARE: JOHN B OXLEY DPT
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
1225100000XPhysical Therapist2565WV

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3P00347484OTHERRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
27180806OTHERAETNA
4001881188OTHERWVMOUNTAIN STATE BCBS
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1609893031
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN B OXLEY DPT
Provider Business Mailing Address
First Line : 2240 5TH AVE
Second Line :
City : HUNTINGTON
State : WV
Zip : 25703-1239
Country : US
Telephone Number : 304-525-4445
Fax Number : 304-529-7449
Provider Business Practice Location Address
First Line : 2240 5TH AVE
Second Line :
City : HUNTINGTON
State : WV
Zip : 25703-1239
Country : US
Telephone Number : 304-525-4445
Fax Number : 304-529-7449
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2006
Last Update Date : 06/03/2020

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