Provider Demographics
NPI:1578502324
Name:WOO, VAN HOY (MD)
Entity Type:Individual
Prefix:
First Name:VAN
Middle Name:HOY
Last Name:WOO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 14145
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74159-1145
Mailing Address - Country:US
Mailing Address - Phone:918-587-1791
Mailing Address - Fax:918-587-1795
Practice Address - Street 1:3300 NW 56TH ST FL LL100
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4499
Practice Address - Country:US
Practice Address - Phone:405-488-0700
Practice Address - Fax:405-720-3910
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04 261402085R0001X
CAG770742085R0001X
OK191572085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100216390AMedicaid
OKRADON004Medicare ID - Type Unspecified
OK100216390AMedicaid