Healthcare Provider Details

I. General information

NPI: 1689276925
Provider Name (Legal Business Name): PAUL PITTS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/11/2020
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 STANTON L YOUNG BLVD
OKLAHOMA CITY OK
73104-5018
US

IV. Provider business mailing address

800 NE 10TH ST # L100
OKLAHOMA CITY OK
73104-5418
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-2316
  • Fax:
Mailing address:
  • Phone: 572-244-0104
  • Fax: 572-244-9987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number45857
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: