MEDICARE: OAKVIEW MEDICINE, 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	261QM2500X	Medical Specialty Clinic/Center	16735	MS

General Provider Information

NPI Number	:	1790922680
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OAKVIEW MEDICINE, LLC

Provider Business Mailing Address
First Line	:	1721 MEDICAL PARK DR
Second Line	:	SUITE 101
City	:	BILOXI
State	:	MS
Zip	:	39532-2109
Country	:	US
Telephone Number	:	228-385-5350
Fax Number	:	228-354-9484

Provider Business Practice Location Address
First Line	:	1721 MEDICAL PARK DR
Second Line	:	SUITE 101
City	:	BILOXI
State	:	MS
Zip	:	39532-2100
Country	:	US
Telephone Number	:	228-385-5350
Fax Number	:	228-354-9484

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DAWN M HANSEN
Credential	:	M.D.
Telephone Number	:	228-385-5350

Provider Enumeration Date	:	01/14/2009
Last Update Date	:	03/20/2013

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Directions to “OAKVIEW MEDICINE, LLC ” Practice Location

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