Provider Demographics
NPI:1588772131
Name:OXFORD ACCIDENT AND INJURY CENTER, INC.
Entity type:Organization
Organization Name:OXFORD ACCIDENT AND INJURY CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:919-693-3577
Mailing Address - Street 1:304 HILLSBORO ST STE D
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27565-3274
Mailing Address - Country:US
Mailing Address - Phone:919-693-3577
Mailing Address - Fax:919-693-3582
Practice Address - Street 1:304 HILLSBORO ST STE D
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:NC
Practice Address - Zip Code:27565-3274
Practice Address - Country:US
Practice Address - Phone:919-693-3577
Practice Address - Fax:919-693-3582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3075111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC085HJOtherBLUE CROSS/BLUE SHIELD
NC89085HJMedicaid
NCP00160884OtherRAILROAD MEDICARE PROGRAM
NC89085HJMedicaid
NC085HJOtherBLUE CROSS/BLUE SHIELD