Healthcare Provider Details

I. General information

NPI: 1679514772
Provider Name (Legal Business Name): ONEITA F TAYLOR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 11/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10109 E. 79TH STREET
TULSA OK
74133
US

IV. Provider business mailing address

10109 E 79TH STREET
TULSA OK
74133
US

V. Phone/Fax

Practice location:
  • Phone: 918-286-5000
  • Fax: 918-249-7532
Mailing address:
  • Phone: 918-286-5000
  • Fax: 918-246-7514

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number15850
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number0419706
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberR9E84
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: