Provider Demographics
NPI:1679631329
Name:RADIATION MEDICINE ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:RADIATION MEDICINE ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURAR
Authorized Official - Prefix:DR
Authorized Official - First Name:LUCIUS
Authorized Official - Middle Name:S
Authorized Official - Last Name:DOH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-607-4520
Mailing Address - Street 1:PO BOX 248856
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73124-8856
Mailing Address - Country:US
Mailing Address - Phone:405-607-4520
Mailing Address - Fax:405-607-4525
Practice Address - Street 1:13900 N PORTLAND AVE STE 165
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73134-4010
Practice Address - Country:US
Practice Address - Phone:405-607-4520
Practice Address - Fax:405-896-9870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100748890AMedicaid
CH9440OtherRAILROAD MEDICARE
OK100748890AMedicaid
OK100748890AMedicaid