OrganizationActive
Oklahoma Cancer Specialists and Research Institute LLC
NPI 1104291236 · MOHS-Micrographic Surgery Physician · Broken Arrow, OK
Provider details
- NPI number
- 1104291236
- Entity type
- Organization
- Primary specialty
- MOHS-Micrographic Surgery PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Daron Street, President(918) 505-3200
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Procedural Dermatology Physician207NS0135X
Allopathic & Osteopathic Physicians
Practice location
800 W Boise Cir Ste 400
Broken Arrow, OK 74012-4974
Phone: (918) 307-0215
Fax: (918) 250-7669
Approximate (ZIP-level) locationGet directions
Mailing address
12697 E 51st St
Tulsa, OK 74146-6236
Registry dates
- Enumerated
- 2015-12-01
- Last updated
- 2025-08-11
- Certified
- 2025-08-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.