Provider Demographics
NPI:1316984420
Name:OXLEY, JILL S (MD)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:S
Last Name:OXLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 LEWIS BAY RD
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-5210
Mailing Address - Country:US
Mailing Address - Phone:508-775-0800
Mailing Address - Fax:
Practice Address - Street 1:40 LEWIS BAY RD
Practice Address - Street 2:CAPE COD SURGICAL ASSOC.
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-5210
Practice Address - Country:US
Practice Address - Phone:508-775-0800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA209635208600000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
3175949OtherCIGNA
MA808088OtherHPHC
MAJ23864OtherBC/BS
248124200OtherOWCP
MA691811OtherTUFTS
P00420396OtherRAILROAD MEDICARE
MA0000029637OtherBMC
MA0142611Medicaid
3801677OtherAETNA
MACA0221Medicare PIN
248124200OtherOWCP