Organization
SHAWNEE 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
3700 N KICKAPOO AVE, STE 108, OKLAHOMA CITY, OK 74804-0007
(405) 418-2200
(405) 418-2201
Mailing address
11101 HEFNER POINTE DR, #232, 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
03/29/2010
Last updated
03/29/2010
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