Provider Demographics
NPI:1154957363
Name:OXFORD FOOT AND ANKLE SPECIALISTS
Entity type:Organization
Organization Name:OXFORD FOOT AND ANKLE SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:BABATUNDE
Authorized Official - Last Name:ADEGBOYEGA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:973-207-1678
Mailing Address - Street 1:83 ABERDEEN RD
Mailing Address - Street 2:
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-2720
Mailing Address - Country:US
Mailing Address - Phone:973-207-1678
Mailing Address - Fax:732-862-1242
Practice Address - Street 1:310 CENTRAL AVE STE 102
Practice Address - Street 2:
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07018-2838
Practice Address - Country:US
Practice Address - Phone:973-207-1678
Practice Address - Fax:732-862-1242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-19
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty