Provider Demographics
NPI:1508914102
Name:OXFORD LUNG PHYSICIANS, P.A.
Entity Type:Organization
Organization Name:OXFORD LUNG PHYSICIANS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:N
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-234-0119
Mailing Address - Street 1:PO BOX 768
Mailing Address - Street 2:2301 S LAMAR BLVD. STE 100
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-0768
Mailing Address - Country:US
Mailing Address - Phone:662-234-0119
Mailing Address - Fax:662-234-0090
Practice Address - Street 1:2301 S LAMAR BLVD STE 100
Practice Address - Street 2:2301 S LAMAR BLVD STE 100
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-5373
Practice Address - Country:US
Practice Address - Phone:662-234-0119
Practice Address - Fax:662-234-0090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS12109,17162,R862053207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS07906092Medicaid
MS00115527Medicaid
MSP00239013OtherMCR UNITED HEALTHCARE
MS05132705Medicaid
MSP00143146OtherMCR UNITED HEALTHCARE
MSF48440Medicare UPIN
MS07906092Medicaid
MSP00239013OtherMCR UNITED HEALTHCARE