Provider Demographics
NPI:1053517524
Name:OAK HILL MEDICAL
Entity type:Organization
Organization Name:OAK HILL MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:BYRNE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:386-345-0003
Mailing Address - Street 1:PO BOX 373
Mailing Address - Street 2:
Mailing Address - City:OAK HILL
Mailing Address - State:FL
Mailing Address - Zip Code:32759-0373
Mailing Address - Country:US
Mailing Address - Phone:386-345-0003
Mailing Address - Fax:386-345-0295
Practice Address - Street 1:185 NORTH ROUTE 1
Practice Address - Street 2:
Practice Address - City:OAK HILL
Practice Address - State:FL
Practice Address - Zip Code:32759
Practice Address - Country:US
Practice Address - Phone:386-345-0003
Practice Address - Fax:386-345-0295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108925Medicare ID - Type Unspecified