OAKWOOD MEDICAL CLINIC (NPI# 1851423057) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851423057 |
| Entity Type | Organization |
| Organization Name | OAKWOOD MEDICAL CLINIC |
| Practice Address |
3626 Old Oakwood Rd Oakwood GA 30566 |
| Practice Telephone | 7705039285 |
| Practice Fax Number | 7702870477 |
| Mailing Telephone | 7705039285 |
| Mailing Fax Number | 7702870477 |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2008-04-24 |
| Authorized Official Name | DR. BASIL L ANDERSON (PRESIDENT) |
| Authorized Official Telephone | 7705039285 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | 0321020 | GA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00469796D | 05 |
| Street Address |
3626 OLD OAKWOOD RD |
| City | OAKWOOD |
| State | GA |
| Zip Code | 30566 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124299177 | Basil L Anderson | Family Medicine | 3626 Old Oakwood Rd, Oakwood, GA 30566-2805 | 2008-03-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811480676 | Travis Core | Physical Therapist | 4220 Mundy Mill Pl Ste 2b, Oakwood, GA 30566 | 2018-06-07 |
| 1174922751 | Luke Lenahan | Physician Assistant | 3931 Mundy Mill Rd., Ste B, Oakwood, GA 30566 | 2014-08-19 |
| 1144584384 | Stephanie Mccullum | Occupational Therapist | 1006 Creeekside Place, Oakwood, GA 30566 | 2012-07-03 |
| 1528357951 | Extended Care Center of Oakwood LLC | Family Medicine | 4205 Mundy Mill Pl., Suite 1, Oakwood, GA 30566 | 2011-04-06 |
| 1265673305 | Patti P Shipp | Counselor | 4347 Mundy Mill Rd Ste A2, Oakwood, GA 30566 | 2009-03-19 |
| 1124281217 | Ionut Radu | Optometrist | 3839 Mundy Mills Road, Oakwood, GA 30566 | 2008-07-08 |
| 1356516116 | Sam's Club Optical | Eyewear Supplier (Equipment, not the service) | 3839 Mundy Mill Road, Oakwood, GA 30566 | 2008-04-23 |
| 1386619526 | Robert O Kelly | Family Medicine | 3931 Mundy Mill Rd., Oakwood, GA 30566 | 2006-02-21 |
| 1003464538 | Nichole Abernathy Hasan | Pharmacist | Walmart Pharmacy, 3827 Mundy Mill Rd, Oakwood, GA 30566 | 2019-08-28 |
| 1366808727 | Eye Site of Oakwood P.C. | Optometrist | 3640 Mundy Mill Road, Suite 146, Oakwood, GA 30566 | 2016-01-14 |
| Find all providers in zip 30566 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
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| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.