Provider Demographics
NPI:1598871550
Name:OIL VALLEY INTERNAL MEDICINE ASSOCIATES PC
Entity Type:Organization
Organization Name:OIL VALLEY INTERNAL MEDICINE ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:LOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:814-827-9675
Mailing Address - Street 1:339 W SPRING ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:TITUSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16354
Mailing Address - Country:US
Mailing Address - Phone:814-827-9675
Mailing Address - Fax:814-827-0216
Practice Address - Street 1:339 W SPRING ST
Practice Address - Street 2:SUITE 102
Practice Address - City:TITUSVILLE
Practice Address - State:PA
Practice Address - Zip Code:16354
Practice Address - Country:US
Practice Address - Phone:814-827-9675
Practice Address - Fax:814-827-0216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2012-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty