Provider Demographics
NPI:1972827046
Name:OKLAHOMA ONCOLOGY AND HEMATOLOGY, P.C.
Entity Type:Organization
Organization Name:OKLAHOMA ONCOLOGY AND HEMATOLOGY, P.C.
Other - Org Name:CANCER CARE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PAST PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:VIKKI
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:CANFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-751-4343
Mailing Address - Street 1:4401 W MEMORIAL RD
Mailing Address - Street 2:138
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134-1785
Mailing Address - Country:US
Mailing Address - Phone:405-936-2812
Mailing Address - Fax:405-936-2891
Practice Address - Street 1:6475 S YALE AVE
Practice Address - Street 2:201
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-7816
Practice Address - Country:US
Practice Address - Phone:918-499-2000
Practice Address - Fax:918-499-2188
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OKLAHOMA ONCOLOGY AND HEMATOLOGY, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-03-18
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
No207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100744480AMedicaid
OK100744480AMedicaid