Healthcare Provider Details

I. General information

NPI: 1578887618
Provider Name (Legal Business Name): OKLAHOMA ONCOLOGY AND HEMATOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2010
Last Update Date: 03/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11100 HEFNER POINTE DR
OKLAHOMA CITY OK
73120-5049
US

IV. Provider business mailing address

4401 W MEMORIAL RD 138
OKLAHOMA CITY OK
73134-1785
US

V. Phone/Fax

Practice location:
  • Phone: 405-749-0415
  • Fax: 405-749-6843
Mailing address:
  • Phone: 405-936-2812
  • Fax: 405-936-2891

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. VIKKI ANN CANFIELD
Title or Position: PAST PRESIDENT
Credential: M.D.
Phone: 405-751-4343