Provider Demographics
NPI:1598044505
Name:OKLAHOMA PROTON RADIATION ONCOLOGY GROUP PC
Entity Type:Organization
Organization Name:OKLAHOMA PROTON RADIATION ONCOLOGY GROUP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:EUGEN
Authorized Official - Middle Name:B
Authorized Official - Last Name:HUG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-773-6700
Mailing Address - Street 1:PO BOX 871678
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64187-1678
Mailing Address - Country:US
Mailing Address - Phone:405-773-6700
Mailing Address - Fax:405-720-3910
Practice Address - Street 1:5901 W MEMORIAL RD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73142-2015
Practice Address - Country:US
Practice Address - Phone:405-773-6700
Practice Address - Fax:405-720-3910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-08
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK283052085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty