Provider Demographics
NPI:1821273491
Name:OXFORD PHYSICAL MEDICINE
Entity Type:Organization
Organization Name:OXFORD PHYSICAL MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:
Authorized Official - First Name:RON
Authorized Official - Middle Name:
Authorized Official - Last Name:MILONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-366-9261
Mailing Address - Street 1:PO BOX 2395
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-7000
Mailing Address - Country:US
Mailing Address - Phone:601-366-9261
Mailing Address - Fax:
Practice Address - Street 1:703 N LAMAR BLVD
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-3242
Practice Address - Country:US
Practice Address - Phone:601-366-9261
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-02
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSC03627Medicare PIN