Provider Demographics
NPI:1427057074
Name:OXFORD RADIOLOGY INC
Entity type:Organization
Organization Name:OXFORD RADIOLOGY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLIENT SERVICES MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-965-8041
Mailing Address - Street 1:PO BOX 729
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45056-0729
Mailing Address - Country:US
Mailing Address - Phone:513-965-8041
Mailing Address - Fax:513-965-8091
Practice Address - Street 1:110 N POPLAR ST
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:OH
Practice Address - Zip Code:45056-1204
Practice Address - Country:US
Practice Address - Phone:513-965-8041
Practice Address - Fax:513-965-8091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-16
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0801403Medicaid
KY65937286Medicaid
OH0801403Medicaid
OH9931091Medicare PIN