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General NPI Number Information
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NPI Number | 1902280639
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Entity Type | Organization
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Legal Business Name | TULCA CANCER INSTITUTE, PLLC
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Dates
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Enumeration Date | 07/13/2015
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Last Update Date | 07/13/2015
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Provider Practice Location Address
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Address Line | 901 N STRONG BLVD
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City | MCALESTER
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State | OK
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Zip | 74501-4206
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Country | US
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Telephone | 918-426-0625
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Fax | 918-423-0695
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Provider Business Mailing Address
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Address Line | 901 N STRONG BLVD
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City | MCALESTER
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State | OK
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Zip | 74501-4206
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Country | US
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Telephone | 918-426-0625
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Fax | 918-423-0695
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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 | M.D.
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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 | 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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Taxonomy #2
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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