Provider Demographics
NPI:1710007547
Name:OEHMS, ERIC ANDREW (MS, ATC)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:ANDREW
Last Name:OEHMS
Suffix:
Gender:M
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:4425 BIGLIN BAYOU DR
Mailing Address - Street 2:
Mailing Address - City:DIBERVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39540-4627
Mailing Address - Country:US
Mailing Address - Phone:228-396-9994
Mailing Address - Fax:228-392-5288
Practice Address - Street 1:1720A MEDICAL PARK DR
Practice Address - Street 2:SUITE 210
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39532-2129
Practice Address - Country:US
Practice Address - Phone:228-392-3499
Practice Address - Fax:228-392-5288
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSAT01572255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer