Provider Demographics
NPI:1649436395
Name:OXFORD SURGICAL AND BARIATRIC CLINIC PLLC
Entity type:Organization
Organization Name:OXFORD SURGICAL AND BARIATRIC CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:WALKER
Authorized Official - Last Name:BYARS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:662-234-4744
Mailing Address - Street 1:PO BOX 590
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-0590
Mailing Address - Country:US
Mailing Address - Phone:662-234-4744
Mailing Address - Fax:662-234-4749
Practice Address - Street 1:506 AZALEA DR
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-8100
Practice Address - Country:US
Practice Address - Phone:662-234-4744
Practice Address - Fax:662-234-4749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-01
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty