Provider Demographics
NPI:1124466040
Name:OAKLEY, NATHAN D (MD)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:D
Last Name:OAKLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 3407
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47733-3407
Mailing Address - Country:US
Mailing Address - Phone:812-450-3363
Mailing Address - Fax:812-450-3071
Practice Address - Street 1:415 W COLUMBIA ST
Practice Address - Street 2:STE 110
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47710-1656
Practice Address - Country:US
Practice Address - Phone:812-450-3363
Practice Address - Fax:812-450-3071
Is Sole Proprietor?:No
Enumeration Date:2013-06-13
Last Update Date:2016-08-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01074330A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN849950007Medicare PIN
IN639880009Medicare PIN