Provider Demographics
NPI:1629019161
Name:JAMES, OSCAR DEAN (MD)
Entity type:Individual
Prefix:
First Name:OSCAR
Middle Name:DEAN
Last Name:JAMES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 VICTORIA DR
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73003-3860
Mailing Address - Country:US
Mailing Address - Phone:405-551-0563
Mailing Address - Fax:
Practice Address - Street 1:4525 NE 38TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73121-6400
Practice Address - Country:US
Practice Address - Phone:405-551-0563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000037356207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3326996Medicaid
OK200121650 AMedicaid
TN3326997Medicare ID - Type Unspecified
OK1629019161Medicare PIN
TN3326996Medicaid