Provider Demographics
NPI:1720026636
Name:OXFORD CIRCLE FAMILY MEDICINE LLC
Entity Type:Organization
Organization Name:OXFORD CIRCLE FAMILY MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:H
Authorized Official - Last Name:CROSS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:215-288-0707
Mailing Address - Street 1:5363 OXFORD AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19124-1123
Mailing Address - Country:US
Mailing Address - Phone:215-288-0707
Mailing Address - Fax:
Practice Address - Street 1:5363 OXFORD AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19124-1123
Practice Address - Country:US
Practice Address - Phone:215-288-0707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA00110310000002Medicaid
PA00110310000002Medicaid