Provider Demographics
NPI:1871931808
Name:OAK MOUNTAIN ONCOLOGY HEMATOLOGY ASSOCIATES LLC
Entity type:Organization
Organization Name:OAK MOUNTAIN ONCOLOGY HEMATOLOGY ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JANE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:GEHLSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-481-8475
Mailing Address - Street 1:PO BOX 383125
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35238-3125
Mailing Address - Country:US
Mailing Address - Phone:205-481-8475
Mailing Address - Fax:205-481-8478
Practice Address - Street 1:985 9TH AVE SW
Practice Address - Street 2:SUITE 404
Practice Address - City:BESSEMER
Practice Address - State:AL
Practice Address - Zip Code:35022-4500
Practice Address - Country:US
Practice Address - Phone:205-481-8475
Practice Address - Fax:205-481-8478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-12
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL17581174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty