Healthcare Provider Details

I. General information

NPI: 1437172434
Provider Name (Legal Business Name): OKLAHOMA ONCOLOGY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1705 E 19TH ST STE 201
TULSA OK
74104-5405
US

IV. Provider business mailing address

1705 E 19TH ST STE 201
TULSA OK
74104-5405
US

V. Phone/Fax

Practice location:
  • Phone: 918-744-3180
  • Fax: 918-744-3187
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number8253
License Number StateOK

VIII. Authorized Official

Name: LANCE MILLER
Title or Position: PRESIDENT MEDICAL DIR
Credential:
Phone: 918-744-3180