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General NPI Number Information
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NPI Number | 1194215723
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Entity Type | Organization
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Legal Business Name | OKLAHOMA CANCER SPECIALISTS AND RESEARCH INSTITUTE, LLC
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Dates
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Enumeration Date | 05/18/2018
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Last Update Date | 02/18/2020
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Provider Practice Location Address
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Address Line | 1836 E 15TH ST
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City | TULSA
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State | OK
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Zip | 74104-4611
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Country | US
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Telephone | 918-585-5658
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Fax | 918-585-5670
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Provider Business Mailing Address
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Address Line | 12697 E 51ST ST
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City | TULSA
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State | OK
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Zip | 74146-6236
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Country | US
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Telephone | 918-505-3200
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Fax | 918-505-3225
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DARON G. STREET
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Credential | MD
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Telephone | 918-505-3200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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