Provider Demographics
NPI:1033398151
Name:MAURICE J. OAKLEY,M.D.,P.S.C.
Entity Type:Organization
Organization Name:MAURICE J. OAKLEY,M.D.,P.S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MAURICE
Authorized Official - Middle Name:J
Authorized Official - Last Name:OAKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:606-329-2211
Mailing Address - Street 1:1901 WINCHESTER AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41101-7758
Mailing Address - Country:US
Mailing Address - Phone:606-329-2211
Mailing Address - Fax:606-324-9207
Practice Address - Street 1:1901 WINCHESTER AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-7758
Practice Address - Country:US
Practice Address - Phone:606-329-2211
Practice Address - Fax:606-324-9207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-25
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY18566207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64185663Medicaid
KY0620301Medicare PIN