Healthcare Provider Details

I. General information

NPI: 1720018906
Provider Name (Legal Business Name): THERAPEUTIC RADIOLOGY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6161 S YALE AVE
TULSA OK
74136-1902
US

IV. Provider business mailing address

6161 S YALE AVE
TULSA OK
74136-1902
US

V. Phone/Fax

Practice location:
  • Phone: 918-494-1028
  • Fax: 918-494-1581
Mailing address:
  • Phone: 918-494-1028
  • Fax: 918-494-1581

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT GORDON SWANSON
Title or Position: RADIATION ONCOLOGIST
Credential: M.D.
Phone: 918-494-1585