Healthcare Provider Details

I. General information

NPI: 1295785392
Provider Name (Legal Business Name): OKLAHOMA ONCOLOGY & HEMATOLOGY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4110 S 100TH EAST AVE 201
TULSA OK
74146-3628
US

IV. Provider business mailing address

4110 S 100TH EAST AVE 201
TULSA OK
74146-3628
US

V. Phone/Fax

Practice location:
  • Phone: 918-499-2165
  • Fax: 918-499-2160
Mailing address:
  • Phone: 918-499-2165
  • Fax: 918-499-2160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. VIKKI A CANFIELD
Title or Position: PRESIDENT
Credential: MD
Phone: 405-751-4343