Provider Demographics
NPI:1235456336
Name:OXFORD OPTICIANS
Entity Type:Organization
Organization Name:OXFORD OPTICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:HICKS
Authorized Official - Suffix:
Authorized Official - Credentials:LDO
Authorized Official - Phone:513-523-6616
Mailing Address - Street 1:39 W HIGH ST
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45056-1710
Mailing Address - Country:US
Mailing Address - Phone:513-523-6616
Mailing Address - Fax:513-523-6616
Practice Address - Street 1:39 W HIGH ST
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:OH
Practice Address - Zip Code:45056-1710
Practice Address - Country:US
Practice Address - Phone:513-523-6616
Practice Address - Fax:513-523-6616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-28
Last Update Date:2010-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1228-SC332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0635170001Medicare UPIN