Oral Surgery Group - Corydon LLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

ORAL SURGERY GROUP - CORYDON LLC

Practice address

2086 Old Hwy 135 NW
1
Corydon, IN 47112-4016

Phone

(502) 254-8500

NPI assigned

Apr 14, 2017

Last updated

Apr 14, 2017By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Stephen C James

Title

Cfo

Phone

(502) 254-8500

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1492128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492128000000",
    "number": "1326572579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2086 OLD HWY 135 NW",
            "address_2": "1",
            "city": "CORYDON",
            "state": "IN",
            "postal_code": "471124016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2086 OLD HWY 135 NW",
            "address_2": "1",
            "city": "CORYDON",
            "state": "IN",
            "postal_code": "471124016",
            "telephone_number": "502-254-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORAL SURGERY GROUP - CORYDON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-14",
        "last_updated": "2017-04-14",
        "status": "A",
        "authorized_official_last_name": "JAMES",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "502-254-8500"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joe Nelson, LCSW
• New Bay Dialysis LLC (Corydon Dialysis Center)
• Thu Minh Nguyen, DMD
• John F. Norton, MD
• Stephanie R Ollis, APRN
• Melisa Overstreet
• Chandler H Park, M.D., MSC
• Ashley Parsons, PT, DPT
• Physical Therapy Works Corydon, Inc.
• Devi Kathleen Pierce, MD

• Oral and Maxillofacial Surgery (Dentist) in Corydon, IN
• Providers in Corydon, IN by specialty
• Oral and Maxillofacial Surgery (Dentist) in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.