White Oak Family Medicine Clinic, LLC
Clinic/Center, Primary Care in Oxford, MS. Organization (NPI-2).
NPI number1073759502
StatusActive
Last updated in NPPESJan 11, 2010
Details
- NPI
- 1073759502
- Entity type
- Organization (NPI-2)
- Legal business name
- White Oak Family Medicine Clinic, LLC
- Organization subpart
- No
- Enumeration date
- Jan 6, 2009
- Last updated
- Jan 11, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QP2300X | Clinic/Center, Primary Care | 17356 | MS | Yes |
Practice location
1190 S 18th Street ExtOxford, MS 38655-5378
Phone 662-236-1927 · Fax 662-236-3727
Mailing address
1190 S 18th Street ExtOxford, MS 38655-5378
Phone 662-236-1927 · Fax 662-236-3727
Authorized official
Erik S Richardson
Owner
6622361927
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