Organization
MUSKOGEE RT ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DEREK PRENTICE (MANAGING MEMBER)
(405) 418-2200
Entity
Organization
Contact information
Practice address
2900 N MAIN ST, MUSKOGEE, OK 74401-4078
(918) 683-6655
(918) 683-6654
Mailing address
11101 HEFNER POINTE DR, #231, OKLAHOMA CITY, OK 73120-5054
(405) 418-2200
(405) 418-2201
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
—
—
Other
Enumeration date
07/02/2009
Last updated
07/10/2009
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