| Ole Town Med | |
|
2580 Jackson Ave W Ste 44 Oxford MS 38655 | |
| (662) 816-7199 | |
| Not Available |
| Full Name | Ole Town Med |
|---|---|
| Speciality | Family Medicine |
| Location | 2580 Jackson Ave W Ste 44, Oxford, Mississippi |
| Authorized Official Name and Position | Laura L Hill (PRESIDENT) |
| Authorized Official Contact | 6628167199 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ole Town Med 2580 Jackson Ave W Ste 44 Oxford MS 38655-5497 Ph: (662) 234-9112 | Ole Town Med 2580 Jackson Ave W Ste 44 Oxford MS 38655 Ph: (662) 816-7199 |
| NPI Number | 1265934012 |
|---|---|
| Provider Enumeration Date | 03/07/2018 |
| Last Update Date | 04/02/2019 |
| Medicare PECOS PAC ID | 8921358128 |
|---|---|
| Medicare Enrollment ID | O20180910002183 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265934012 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Gena A Vail |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649204629 PECOS PAC ID: 4385556398 Enrollment ID: I20040903000368 |
| Provider Name | Laura L Hill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295169019 PECOS PAC ID: 9830328731 Enrollment ID: I20140702000623 |
| Provider Name | Robert I Vail |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326593336 PECOS PAC ID: 0749192755 Enrollment ID: I20161130000176 |
| Provider Name | Kevin A Floyd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174075220 PECOS PAC ID: 0345524021 Enrollment ID: I20170223001950 |
| Provider Name | Karla Michelle Burnett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689129470 PECOS PAC ID: 9133415078 Enrollment ID: I20190709002434 |
| Provider Name | Sarah Catherine Morrow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972118701 PECOS PAC ID: 1254751787 Enrollment ID: I20201021001909 |
| Provider Name | Jason Allen Mccain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740896745 PECOS PAC ID: 9436309358 Enrollment ID: I20210127001066 |
| Provider Name | Samantha Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710593462 PECOS PAC ID: 1658769005 Enrollment ID: I20211104000103 |
| Provider Name | Lisa King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558918540 PECOS PAC ID: 4183010713 Enrollment ID: I20220408000270 |
| Provider Name | Georganna Belle Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548989882 PECOS PAC ID: 9739557273 Enrollment ID: I20221115000926 |
| Provider Name | Kirsten A Cox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063123453 PECOS PAC ID: 0749654226 Enrollment ID: I20230323002598 |
| Provider Name | Macey L Chrestman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831887728 PECOS PAC ID: 1557728391 Enrollment ID: I20230608003161 |
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