Healthcare Provider Details
I. General information
NPI: 1972827046
Provider Name (Legal Business Name): OKLAHOMA ONCOLOGY AND HEMATOLOGY, P.C.
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
6475 S YALE AVE 201
TULSA OK
74136-7816
US
IV. Provider business mailing address
4401 W MEMORIAL RD 138
OKLAHOMA CITY OK
73134-1785
US
V. Phone/Fax
- Phone: 918-499-2000
- Fax: 918-499-2188
- Phone: 405-936-2812
- Fax: 405-936-2891
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207VX0201X |
| Taxonomy | Gynecologic Oncology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & 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