Provider Demographics
NPI:1659645166
Name:ONCOLOGY CONSULTANTS OF NORTHWEST OKLAHOMA P.C.
Entity Type:Organization
Organization Name:ONCOLOGY CONSULTANTS OF NORTHWEST OKLAHOMA P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:S
Authorized Official - Last Name:ERBA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:580-233-3843
Mailing Address - Street 1:PO BOX 5096
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73702-5096
Mailing Address - Country:US
Mailing Address - Phone:580-233-3843
Mailing Address - Fax:
Practice Address - Street 1:600 S MONROE ST
Practice Address - Street 2:RAD ONC DEPT.
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701-7211
Practice Address - Country:US
Practice Address - Phone:580-548-1131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-01
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK164112085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty