Individual
JACQUELINE CLARE OXENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1000 EAST MOUNTAIN BLVD., WILKES-BARRE, PA 18711-3762
(570) 808-2340
(570) 808-7904
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
(570) 271-6578
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
263687
NY
208600000X
Surgery Physician
OS014772
PA
208600000X
Surgery Physician
OT012136
PA
2086X0206X
Surgical Oncology Physician
Primary
OS014772
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102920739
—
PA
Enumeration date
08/20/2008
Last updated
07/30/2020
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