Organization
WHITE OAK FAMILY MEDICINE CLINIC, LLC
Active
Organization
WHITE OAK FAMILY MEDICINE CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ERIK S RICHARDSON M.D. (OWNER)
(662) 236-1927
Entity
Organization
Contact information
Practice address
1190 S 18TH STREET EXT, OXFORD, MS 38655-5378
(662) 236-1927
(662) 236-3727
Mailing address
1190 S 18TH STREET EXT, OXFORD, MS 38655-5378
(662) 236-1927
(662) 236-3727
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
17356
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
302G088746
GROUP PTAN
MS
01
—
302I088746
INDIVIDUAL PTAN
MS
Enumeration date
01/06/2009
Last updated
01/11/2010
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