Organization
OXFORD FAMILY EYECARE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MALCOLM H. KELLY JR. OD (PRESIDENT)
(610) 932-9356
Entity
Organization
Contact information
Practice address
49 S 2ND ST, OXFORD, PA 19363-1370
(610) 932-9356
(610) 932-3097
Mailing address
49 S 2ND ST, OXFORD, PA 19363-1370
(610) 932-9356
(610) 932-3097
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000335
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001515704
HIGHMARK ID
PA
01
—
112071
EYEMED ID NO.
PA
01
—
2203236000
IBC HMO ID
PA
01
—
3634856
AETNA HMO
PA
01
—
4511161
AETNA - PPO
PA
01
—
5426540001
DMERC JURISDICTION A
PA
01
—
55863
DAVIS VISION
PA
Enumeration date
05/24/2006
Last updated
08/18/2010
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