Provider Demographics
NPI:1942237086
Name:OEHLER, JAMES R (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:R
Last Name:OEHLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25507 BEAU CHENE CT
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748-1803
Mailing Address - Country:US
Mailing Address - Phone:734-604-8608
Mailing Address - Fax:
Practice Address - Street 1:25507 BEAU CHENE CT
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-1803
Practice Address - Country:US
Practice Address - Phone:734-604-8608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-26
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME114894207P00000X
MI3684189207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1436153Medicaid
MI3397107Medicaid
MI4797130Medicaid
MIJO035083OtherBC/BS
MIJO035083OtherBC/BS
MI4797130Medicaid
MIM60660317Medicare PIN