Individual
DIANE M HEATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1120 S UTICA AVE, TULSA, OK 74104-4012
(918) 774-2071
(918) 579-8204
Mailing address
PO BOX 21228, TULSA, OK 74121-1228
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
18768
OK
2085R0203X
Therapeutic Radiology Physician
18768
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100056850A
—
OK
01
—
920001079
RAILROAD MEDICARE
OK
Enumeration date
10/19/2005
Last updated
04/02/2026
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