Provider Demographics
NPI:1578644167
Name:OXFORD OBSTETRICS AND GYNECOLOGY, INC.
Entity Type:Organization
Organization Name:OXFORD OBSTETRICS AND GYNECOLOGY, INC.
Other - Org Name:OXFORD OB/GYN, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:T
Authorized Official - Last Name:HARLAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-523-2158
Mailing Address - Street 1:5225 MORNING SUN RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:OXFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45056-8929
Mailing Address - Country:US
Mailing Address - Phone:513-523-2158
Mailing Address - Fax:513-523-0019
Practice Address - Street 1:10058 COOLEY RD
Practice Address - Street 2:SUITE A
Practice Address - City:BROOKVILLE
Practice Address - State:IN
Practice Address - Zip Code:47012-9509
Practice Address - Country:US
Practice Address - Phone:765-647-2677
Practice Address - Fax:765-647-4114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100022790Medicaid
OH0313306Medicaid
IN100022790Medicaid
OHOX9934672Medicare ID - Type Unspecified