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General NPI Number Information
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NPI Number | 1932574068
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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 | 12/01/2015
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Last Update Date | 12/01/2015
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Provider Practice Location Address
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Address Line | 600 S ADAMS ST
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City | STILLWATER
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State | OK
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Zip | 74074-4370
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Country | US
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Telephone | 405-372-1775
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Fax | 405-372-1802
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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 | 918-499-2141
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Fax | 918-499-2141
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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 | 207VX0201X
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Taxonomy Name | Gynecologic 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 | 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 #3
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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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