Provider Demographics
NPI:1831482496
Name:OXFORD DIALYSIS ASSOCIATES, PC
Entity Type:Organization
Organization Name:OXFORD DIALYSIS ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JON
Authorized Official - Middle Name:H
Authorized Official - Last Name:MASSEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:662-232-8005
Mailing Address - Street 1:1300 ACCESS RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-5209
Mailing Address - Country:US
Mailing Address - Phone:662-232-8005
Mailing Address - Fax:
Practice Address - Street 1:1300 ACCESS RD
Practice Address - Street 2:SUITE 300
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-5209
Practice Address - Country:US
Practice Address - Phone:662-232-8005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-16
Last Update Date:2011-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS13545207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty