Oakwood Medical Clinic

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

0321020 Issued in GA

Legal business name

OAKWOOD MEDICAL CLINIC

Practice address

3626 Old Oakwood Rd
Oakwood, GA 30566

Phone

(770) 503-9285

Fax

(770) 287-0477

NPI assigned

Mar 12, 2007

Last updated

Apr 24, 2008By 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

Dr. Basil L Anderson, MD

Title

President

Phone

(770) 503-9285

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208995200000",
    "number": "1851423057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3626 OLD OAKWOOD RD",
            "city": "OAKWOOD",
            "state": "GA",
            "postal_code": "30566",
            "telephone_number": "770-503-9285",
            "fax_number": "770-287-0477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3626 OLD OAKWOOD RD",
            "city": "OAKWOOD",
            "state": "GA",
            "postal_code": "30566",
            "telephone_number": "770-503-9285",
            "fax_number": "770-287-0477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAKWOOD MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2008-04-24",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "BASIL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-503-9285",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "GA",
            "license": "0321020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00469796D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Oakwood, GA
• Providers in Oakwood, GA by specialty
• Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2008; 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.