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General NPI Number Information
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NPI Number | 1720018906
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Entity Type | Organization
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Legal Business Name | THERAPEUTIC RADIOLOGY INC.
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6161 S YALE AVE
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City | TULSA
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State | OK
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Zip | 74136-1902
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Country | US
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Telephone | 918-494-1028
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Fax | 918-494-1581
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Provider Business Mailing Address
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Address Line | 6161 S YALE AVE
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City | TULSA
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State | OK
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Zip | 74136-1902
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Country | US
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Telephone | 918-494-1028
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Fax | 918-494-1581
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Authorized Official
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Title or Position | RADIATION ONCOLOGIST
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Name | MR. ROBERT GORDON SWANSON
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Credential | M.D.
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Telephone | 918-494-1585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number |
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License Number State |
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