SOUTH TULSA RT ASSOCIATES LLC (NPI# 1760644587) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760644587 |
| Entity Type | Organization |
| Organization Name | SOUTH TULSA RT ASSOCIATES LLC |
| Practice Address |
2408 E 81st St Ste 110 Tulsa OK 74137-4215 |
| Mailing Address |
11101 Hefner Pointe Dr #224 Oklahoma City OK 73120-5054 |
| Practice Telephone | 9183882300 |
| Practice Fax Number | 9183882301 |
| Mailing Telephone | 4054182200 |
| Mailing Fax Number | 4054182201 |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2008-10-07 |
| Authorized Official Name | MR. DEREK M PRENTICE (MANAGING MEMBER) |
| Authorized Official Telephone | 4054182200 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
Allopathic & Osteopathic Physicians |
| Street Address |
2408 E 81ST ST STE 110 |
| City | TULSA |
| State | OK |
| Zip Code | 74137-4215 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487651857 | Oklahoma Surgical Hospital, LLC | General Acute Care Hospital | 2408 E 81st St, Ste 900, Tulsa, OK 74137-4217 | 2005-06-30 |
| 1033732557 | Michele Stern | Radiologic Technologist | 2408 E 81st St, Tulsa, OK 74137-4200 | 2020-05-19 |
| 1548898935 | Matthew Evan Marble | Nurse Practitioner | 2408 E 81st St, Tulsa, OK 74137-4200 | 2020-03-31 |
| 1851715668 | Autumn Thornton | Specialist/Technologist, Other | 2408 E 81st St, Suite 900, Tulsa, OK 74137-4200 | 2014-02-13 |
| 1578986964 | Lauren Michelle Blase | Physical Therapist | 2408 E 81st St, Tulsa, OK 74137-4200 | 2014-01-21 |
| 1124451455 | Tulsa-amg Specialty Hospital, LLC | Long Term Care Hospital | 2408 E 81st St, Ste 2800, Tulsa, OK 74137-4200 | 2013-08-09 |
| 1093083727 | Oncology Development Services | Clinic/Center | 2408 E 81st St, Suite 110, Tulsa, OK 74137-4200 | 2011-12-08 |
| 1568770105 | Oncology Services LLC | Internal Medicine | 2408 E 81st St, Suite 110, Tulsa, OK 74137-4200 | 2010-09-16 |
| 1386800019 | Northeast Oklahoma Eye Institute | General Acute Care Hospital | 2408 E 81st St, Suite 600, Tulsa, OK 74137-4200 | 2008-08-01 |
| 1578749065 | Oklahoma Surgical Hospital, LLC | Radiology | 2408 E 81st St, Ste 900, Tulsa, OK 74137-4217 | 2008-01-14 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205487493 | Christopher Thibeault | Physician Assistant | 10326 S Oswego Ave, Tulsa, OK 74137 | 2019-09-27 |
| 1851896237 | Leslie King | Nurse Practitioner | 4809 East 89th Street South, Suite 100, Tulsa, OK 74137 | 2018-03-27 |
| 1245756428 | Olakunle Ajanaku | Dentist | 4818 East 113th Place South, Tulsa, OK 74137 | 2017-08-18 |
| 1831610096 | Cameron Craig | Dentist | 9671 South Riverside Drive East, Tulsa, OK 74137 | 2017-06-28 |
| 1669915336 | Verum Health | Chiropractor | 5014 East 101st Street, Suite 200, Tulsa, OK 74137 | 2016-11-29 |
| 1518327014 | Richard A Felmlee | General Practice | 8955 S. College Place, Tulsa, OK 74137 | 2016-02-26 |
| 1164815395 | John F Carletti Dds Prof Corp | Dentist | 2808 E. 101st St., Tulsa, OK 74137 | 2015-03-12 |
| 1023356581 | The Bair Foundation | Exclusive Provider Organization | 2921 E. 91st St, Tulsa, OK 74137 | 2013-01-17 |
| 1588900328 | Isaac Newton Causey | Counselor | 9325 S. Erie Avenue, Tulsa, OK 74137 | 2012-12-26 |
| 1952656894 | Crystal I Phillips | Behavioral Analyst | 2921 E 91st, Tulsa, OK 74137 | 2012-07-17 |
| Find all providers in zip 74137 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932111739 | Robert George Ellis | Radiology | 1204 E 29th St, Tulsa, OK 74114-3907 | 2006-08-12 |
| 1437148954 | Nathan Wilson Uy I | Radiology | 12697 E 51st St, Tulsa, OK 74146-6236 | 2005-10-18 |
| 1467992230 | South Tulsa Oncology Professionals Cancer Associates | Radiology | 1120 S Utica Ave, Tulsa, OK 74104-4012 | 2017-02-27 |
| 1366897357 | Andrea Kellogg | Radiology | 4502 E 41st St, Tulsa, OK 74135-2536 | 2016-04-27 |
| 1437544228 | Nilan Naik | Radiology | 10109 E 79th St, Tulsa, OK 74133-4564 | 2015-03-30 |
| 1538483698 | Oklahoma Oncology and Hematology, P.C. | Radiology | 9320 S Mingo Rd, Tulsa, OK 74133-5710 | 2010-03-18 |
| 1598927618 | Radiation Therapy Specialists of Tulsa, Pllc | Radiology | 6161 S Yale Ave, Tulsa, OK 74136-1902 | 2008-06-30 |
| 1174784540 | Walter Edwin Watts Iv | Radiology | 1120 S Utica Ave, Tulsa, OK 74104-4012 | 2008-06-18 |
| 1821115304 | Elesyia D. Outlaw | Radiology | 10109 E. 79th Street, Tulsa, OK 74133 | 2007-03-22 |
| 1548319940 | Stephen Zohar Sack | Radiology | 11212 E 48th St, Tulsa, OK 74146-5824 | 2007-01-09 |
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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.