Provider Demographics
NPI:1508032517
Name:UROLOGY OF OXFORD
Entity Type:Organization
Organization Name:UROLOGY OF OXFORD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DENIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:YALKUT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-893-6600
Mailing Address - Street 1:1100 KALONE WAY
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40515-5430
Mailing Address - Country:US
Mailing Address - Phone:859-893-6600
Mailing Address - Fax:859-623-5921
Practice Address - Street 1:2166 S LAMAR BLVD
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-5224
Practice Address - Country:US
Practice Address - Phone:859-893-6600
Practice Address - Fax:859-623-5921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-30
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00119551Medicaid
MS3400000274Medicare NSC
MSG69251Medicare UPIN
KY1275621Medicare PIN