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NPI Code Detail

MEDICARE: OXFORD PROFESSIONAL GROUP, P.C.

MEDICARE: OXFORD PROFESSIONAL GROUP, P.C.
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
1207R00000XInternal Medicine Physician
22084P0802XAddiction Psychiatry Physician

General Provider Information

NPI Number : 1710354964
Entity Type Code : Organization
Provider Name (Legal Business Name) : OXFORD PROFESSIONAL GROUP, P.C.
Provider Business Mailing Address
First Line : 200 POWELL PL
Second Line : ATTN: LEGAL DEPARTMENT
City : BRENTWOOD
State : TN
Zip : 37027-7514
Country : US
Telephone Number : 615-732-1605
Fax Number :
Provider Business Practice Location Address
First Line : 297 COUNTY ROAD 244
Second Line : STE. 100
City : ETTA
State : MS
Zip : 38627
Country : US
Telephone Number : 662-281-9992
Fax Number : 615-457-8094
Authorized Official
Title or Position : FACILITY CEO
Name : MARK A CALARCO
Credential : DO
Telephone Number : 615-712-5862
Provider Enumeration Date : 08/24/2015
Last Update Date : 08/25/2021

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