CANCER CENTERS OF SOUTHWEST OKLAHOMA, LLC (NPI# 1578712675) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578712675 |
| Entity Type | Organization |
| Organization Name | CANCER CENTERS OF SOUTHWEST OKLAHOMA, LLC |
| Other Organization Name | SOUTHWEST OKLAHOMA CANCER CENTER, L.L.C. |
| Practice Address |
2110 Duncan Regional Loop Duncan OK 73533-1568 |
| Mailing Address |
104 Nw 31st St Lawton OK 73505-6100 |
| Practice Telephone | 5802516600 |
| Practice Fax Number | 5802516627 |
| Mailing Telephone | 5805362121 |
| Mailing Fax Number | 5805362150 |
| Enumeration Date | 2008-09-12 |
| Last Update Date | 2012-01-27 |
| Authorized Official Name | MR. JAMES L HOOTON (CHIEF OPERATING OFFICER) |
| Authorized Official Telephone | 5805362121 |
| Is Organization Subpart | Y |
| Parent Organization Name | CANCER CENTERS OF SOUTHWEST OKLAHOMA, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085R0001X |
Radiology Specialization: Radiation Oncology |
OK | Allopathic & Osteopathic Physicians | |
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
OK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | NSC | 6502330003 | 01 |
| OK | 200280260D | 05 | |
| OK | 200280260A | 05 |
| Other Name | Type Code |
|---|---|
| Southwest Oklahoma Cancer Center, L.L.C. | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821528662 | Cancer Centers of Southwest Oklahoma, LLC | Internal Medicine | 210 South Mary Bailey Drive, Chickasha, OK 73018 | 2017-06-14 |
| 1609041136 | Cancer Centers of Southwest Oklahoma, LLC | Radiology | 1200 E Broadway St, Altus, OK 73521-5702 | 2008-04-25 |
| 1952550659 | Cancer Centers of Southwest Oklahoma, LLC | Clinic/Center | 3401 W Gore Blvd, Lawton, OK 73505-6332 | 2008-09-17 |
| 1912156035 | Cancer Centers of Southwest Oklahoma, LLC | Clinic/Center | 1407 Whisenant Drive, Duncan, OK 73533-1650 | 2008-09-12 |
| 1073787792 | Cancer Centers of Southwest Oklahoma, LLC | Radiology | 104 Nw 31st St, Lawton, OK 73505-6100 | 2008-04-14 |
| Street Address |
2110 DUNCAN REGIONAL LOOP |
| City | DUNCAN |
| State | OK |
| Zip Code | 73533-1568 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730723362 | Stefanie Alexis Dubicki | Physician Assistant | 1120 Us-81 N, Duncan, OK 73533 | 2019-11-06 |
| 1568935898 | Grace Elizabeth Peters | Physician Assistant | 1120 Us 81, Duncan, OK 73533 | 2019-01-09 |
| 1427406487 | Joseph Suarez | Behavioral Analyst | 23 N 8th, Duncan, OK 73533 | 2016-06-01 |
| 1386086148 | Andrea R Daughtrey | Behavioral Analyst | 209 S 21 St, Duncan, OK 73533 | 2013-07-22 |
| 1578830873 | Carlton D. Mitchell II | Social Worker | 1919 Elk, Duncan, OK 73533 | 2011-11-30 |
| 1336460468 | Dawn Price | Counselor | 7 1/2 N. 8th St, Duncan, OK 73533 | 2010-06-11 |
| 1740416395 | Sanford Clinic | Pediatrics | 2502 W. Elk Ave., Duncan, OK 73533 | 2009-06-09 |
| 1972788222 | Thelma Joann Dillard | Dentist | 1415 W Main Street, Duncan, OK 73533 | 2008-01-07 |
| 1659560548 | Julia Gayle Case | Nurse Practitioner | 2004 North Hwy 81, Duncan, OK 73533 | 2007-10-17 |
| 1407060395 | Cynthia Annette Browning | Speech-Language Pathologist | 1400 Whisenant, Duncan, OK 73533 | 2007-05-09 |
| Find all providers in zip 73533 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548725302 | Saint Medical Group, LLC | Internal Medicine | 3525 Nw 56th St Ste 150c, Oklahoma City, OK 73112-4516 | 2019-02-06 |
| 1659886893 | Ssm Healthcare of Oklahoma, Inc | Internal Medicine | 1614 Professional Cir, Yukon, OK 73099-6314 | 2017-12-11 |
| 1114430022 | Ssm Health Care of Oklahoma Inc | Internal Medicine | 3525 Nw 56th St Ste 100d, Oklahoma City, OK 73112-4549 | 2017-11-14 |
| 1821528662 | Cancer Centers of Southwest Oklahoma, LLC | Internal Medicine | 210 South Mary Bailey Drive, Chickasha, OK 73018 | 2017-06-14 |
| 1730403882 | Oklahoma Oncology and Hematology, P.C. | Internal Medicine | 1810 E 15th St, Tulsa, OK 74104-4611 | 2010-03-18 |
| 1851615918 | Oklahoma Oncology and Hematology, P.C. | Internal Medicine | 1220 W Willow Rd Ste A, Enid, OK 73703-2529 | 2010-03-18 |
| 1902137540 | Hassan Hatoum | Internal Medicine | 800 Ne 10th St. Okcc 2001-6, Stephenson Cancer Center//university of Oklahoma Health, Oklahoma City, OK 73104 | 2010-01-21 |
| 1235397654 | Agnel Rajani Raparthi | Internal Medicine | 800 Ne 10th St # 6071, Oklahoma City, OK 73104-5418 | 2008-06-02 |
| 1225229461 | Roseleen Sadruddin Charania | Internal Medicine | 1227 E 9th St, Edmond, OK 73034-5708 | 2007-08-05 |
| 1629282389 | Christopher Mark Manus | Internal Medicine | 3470 E Frank Phillips Blvd, Bartlesville, OK 74006-2406 | 2007-05-10 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.