CANCER CENTERS OF SOUTHWEST OKLAHOMA, LLC


Address: 1200 E Broadway St, Altus, OK 73521-5702
Phone: 5804804400

CANCER CENTERS OF SOUTHWEST OKLAHOMA, LLC (NPI# 1609041136) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1609041136
Entity Type Organization
Organization Name CANCER CENTERS OF SOUTHWEST OKLAHOMA, LLC
Other Organization Name SOUTHWEST OKLAHOMA CANCER CENTER, L.L.C.
Practice Address 1200 E Broadway St
Altus
OK 73521-5702
Mailing Address 104 Nw 31st St
Lawton
OK 73505-6100
Practice Telephone 5804804400
Practice Fax Number 5804804416
Mailing Telephone 5805362121
Mailing Fax Number 5805362150
Enumeration Date 2008-04-25
Last Update Date 2012-01-27
Authorized Official Name MR. JAMES L HOOTON (CHEIF OPERATING OFFICER)
Authorized Official Telephone 5805362121
Is Organization Subpart Y
Parent Organization Name CANCER CENTERS OF SOUTHWEST OKLAHOMA, LLC

Taxonomy

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

Other Provider Identifier

State Issuer Identifier Type Code
OK 200280260E 05
OK 200280260C 05
OK NSC 6502330002 01

Other Provider/Organization Names

Other Name Type Code
Southwest Oklahoma Cancer Center, L.L.C. Former Legal Business Name - Organization

Other Provider IDs and Locations

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
1578712675 Cancer Centers of Southwest Oklahoma, LLC Radiology 2110 Duncan Regional Loop, Duncan, OK 73533-1568 2008-09-12
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

Office Location

Street Address 1200 E BROADWAY ST
City ALTUS
State OK
Zip Code 73521-5702

Providers in the same location

NPI Name Taxonomy Address Enumeration
1376095331 Morgan P Johns Clinical Nurse Specialist 1200 E Broadway St, Altus, OK 73521-5702 2016-10-25

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1982263752 Shortgrass Community Health Center, Inc Clinic/Center 211 East Broadway, Altus, OK 73521 2019-06-06
1598025827 Dustin James Robins Counselor 1052 E Cherry St, Altus, OK 73521 2012-05-21
1831471101 Manda Lea Stephens Nurse Practitioner 205 S. Park Lane, Altus, OK 73521 2011-09-13
1649439167 Lisa Michelle Shelton Pharmacist 2500 N Main, Altus, OK 73521 2008-06-09
1114192911 Richard G. Henry Health Maintenance Organization 112 Val Verde, Altus, OK 73521 2008-04-23
1194881060 Resters Diabetic Shoes and Home Medical Durable Medical Equipment & Medical Supplies 103 West Commerce Street, Altus, OK 73521 2006-12-28
1265592141 Noble L Ballard.medical Clinic, Pllc Family Medicine 1015 East Broadway Street, Stuite 101, Altus, OK 73521 2006-12-11
1457377822 Comanche County Healthcare Family Medicine 3000 N Main St, Suite A, Altus, OK 73521 2006-07-15
1326095381 Charles C Carter Md Dph Pllc Family Medicine 1015 E Broadway St, Suite 102, Altus, OK 73521 2006-05-27
1013988179 Carol Marie Sherman Family Medicine 205 S Park Ln, Altus, OK 73521 2006-01-27
Find all providers in zip 73521

Taxonomy Information

Taxonomy Code 207RH0003X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Hematology & Oncology

Taxonomy Definition

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

Providers in the same taxonomy and state

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

Competitor

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City ALTUS
Zip Code 73521

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Dataset Information

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.

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