Provider Demographics
NPI:1265269617
Name:OXFORD UROLOGY ASSOCIATES, PLLC
Entity type:Organization
Organization Name:OXFORD UROLOGY ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:GARDNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-234-1448
Mailing Address - Street 1:PO BOX 1013
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-1013
Mailing Address - Country:US
Mailing Address - Phone:662-234-1448
Mailing Address - Fax:
Practice Address - Street 1:2168 S LAMAR BLVD
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-5224
Practice Address - Country:US
Practice Address - Phone:662-234-1448
Practice Address - Fax:662-234-5374
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OXFORD UROLOGY ASSOCIATES, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-09-18
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site