Provider Demographics
NPI:1013073402
Name:OAKWOOD GROUP IX
Entity Type:Organization
Organization Name:OAKWOOD GROUP IX
Other - Org Name:OAKWOOD WOUND CARE CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:DIVISION PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:IPPEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-266-2780
Mailing Address - Street 1:26650 EUREKA RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180-4835
Mailing Address - Country:US
Mailing Address - Phone:734-941-0573
Mailing Address - Fax:734-941-1101
Practice Address - Street 1:26650 EUREKA RD
Practice Address - Street 2:SUITE C
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180-4835
Practice Address - Country:US
Practice Address - Phone:734-941-0573
Practice Address - Fax:734-941-1101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
Not Answered208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Not Answered2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty
Not Answered213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
Not Answered213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty