Organization
OXFORD SPECIALTY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIDGETT GREEN CFNP (OWNER)
(662) 638-3412
Entity
Organization
Contact information
Practice address
1205 OFFICE PARK DR, OXFORD, MS 38655-3545
(662) 638-3412
Mailing address
PO BOX 1454, OXFORD, MS 38655-1454
(662) 638-3412
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07431342
—
MS
Enumeration date
09/01/2020
Last updated
10/29/2020
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