Provider Demographics
NPI:1841461043
Name:WALTER H. OXLEY,OD
Entity type:Organization
Organization Name:WALTER H. OXLEY,OD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:A
Authorized Official - Last Name:GALLAGHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-334-9779
Mailing Address - Street 1:126 S FRONT ST
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:OH
Mailing Address - Zip Code:43420-3022
Mailing Address - Country:US
Mailing Address - Phone:419-334-9779
Mailing Address - Fax:419-334-4545
Practice Address - Street 1:126 S FRONT ST
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:OH
Practice Address - Zip Code:43420-3022
Practice Address - Country:US
Practice Address - Phone:419-334-9779
Practice Address - Fax:419-334-4545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-14
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3041/T585152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0149760001Medicare NSC
OH9327151Medicare PIN