1851615918 NPI number — OKLAHOMA ONCOLOGY AND HEMATOLOGY, P.C.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851615918 NPI number — OKLAHOMA ONCOLOGY AND HEMATOLOGY, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OKLAHOMA ONCOLOGY AND HEMATOLOGY, P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1851615918
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/18/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4401 W MEMORIAL RD
Provider Second Line Business Mailing Address:
138
Provider Business Mailing Address City Name:
OKLAHOMA CITY
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73134-1785
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
405-936-2812
Provider Business Mailing Address Fax Number:
405-936-2891

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1220 W WILLOW RD STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ENID
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73703-2529
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
580-234-6200
Provider Business Practice Location Address Fax Number:
580-234-6225
Provider Enumeration Date:
03/18/2010

Additional Information

Authorized Official

Authorized Official Last Name:
CANFIELD
Authorized Official First Name:
VIKKI
Authorized Official Middle Name:
ANN
Authorized Official Title or Position:
PAST PRESIDENT
Authorized Official Telephone Number:
405-751-4343

Provider Taxonomy Codes

  • Taxonomy code: 207RH0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 100744480A , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".




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