Provider Demographics
NPI:1194760413
Name:CARDIOLOGY CONSULTANTS OF OXFORD
Entity type:Organization
Organization Name:CARDIOLOGY CONSULTANTS OF OXFORD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:PURDON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:662-236-1352
Mailing Address - Street 1:2209 JEFFERSON DAVIS DR
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-5221
Mailing Address - Country:US
Mailing Address - Phone:662-236-1352
Mailing Address - Fax:662-236-6828
Practice Address - Street 1:2209 JEFFERSON DAVIS DR
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-5221
Practice Address - Country:US
Practice Address - Phone:662-236-1352
Practice Address - Fax:662-236-6828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-19
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS09012130Medicaid
MSC00667Medicare PIN