Provider Demographics
NPI:1508890633
Name:OAKLEY, DAVID E (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:E
Last Name:OAKLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:79 WAWECUS STREET
Mailing Address - Street 2:SUITE 105
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360
Mailing Address - Country:US
Mailing Address - Phone:860-886-0161
Mailing Address - Fax:860-889-5999
Practice Address - Street 1:79 WAWECUS STREET
Practice Address - Street 2:SUITE 105
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360
Practice Address - Country:US
Practice Address - Phone:860-886-0161
Practice Address - Fax:860-889-5999
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT017231207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT031180OtherHEALTH NET
P881662OtherOXFORD
454251OtherAETNA
773172OtherCONNECTICARE
CT001172311Medicaid
CT010017231CT02OtherBCS
0804886OtherUNITED HEALTHCARE
6198703004OtherCIGNA
NY109431OtherPREFERRED ONE
773172OtherCONNECTICARE
P881662OtherOXFORD
CT0231170001Medicare NSC