Organization
BLYTHEVILLE RT ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DEREK M PRENTICE (MANAGING MEMBER)
(405) 418-2200
Entity
Organization
Contact information
Practice address
1522 N DIVISION ST, BLYTHEVILLE, AR 72315-1448
(870) 762-1400
(870) 762-1403
Mailing address
11101 HEFNER POINTE DR, STE 209, OKLAHOMA CITY, OK 73120-5054
(405) 418-2900
(405) 418-2907
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
—
—
Other
Enumeration date
05/21/2013
Last updated
05/21/2013
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