Provider Demographics
NPI:1790989473
Name:EASTERN OKLAHOMA RADIATION ASSOCIATES, LLC
Entity Type:Organization
Organization Name:EASTERN OKLAHOMA RADIATION ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VAN
Authorized Official - Middle Name:HOY
Authorized Official - Last Name:WOO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:918-587-1791
Mailing Address - Street 1:11032 QUAIL CREEK RD STE 165
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-6208
Mailing Address - Country:US
Mailing Address - Phone:405-418-2900
Mailing Address - Fax:405-418-2901
Practice Address - Street 1:3700 N KICKAPOO AVE STE 108
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74804
Practice Address - Country:US
Practice Address - Phone:918-283-9900
Practice Address - Fax:918-283-9911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-14
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty