Individual
KEVIN S OXLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
527 MEDICAL PARK DR STE 401, BRIDGEPORT, WV 26330-9010
(681) 342-3570
(681) 342-3575
Mailing address
527 MEDICAL PARK DR STE 401, BRIDGEPORT, WV 26330-9010
(681) 342-3570
(681) 342-3575
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
22083
WV
208D00000X
General Practice Physician
22083
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3810012488
MEDICAID
WV
01
—
4237641
MEDICARE PTAN
WV
Enumeration date
06/29/2007
Last updated
04/05/2022
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