NPI 1104291236

Oklahoma Cancer Specialists and Research Institute LLC

Organisation MOHS-Micrographic Surgery Physician Broken Arrow, OK

Practice location

Address: 800 W Boise Cir STE 400, Broken Arrow, OK 74012-4974
Phone: (918) 307-0215
Fax: (918) 250-7669
Mailing address: 12697 E 51st St, Tulsa, OK 74146-6236

Authorised official

Name: Daron G. Street
Title: President
Phone: (918) 505-3200

Registered specialties (2)

MOHS-Micrographic Surgery Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207ND0101X

Other Dermatology providers in Oklahoma →

Procedural Dermatology Physician

Allopathic & Osteopathic Physicians Taxonomy 207NS0135X

Registry record

NPI: 1104291236
Entity type: Organization
NPI issued: 1 Dec 2015
Record last updated: 11 Aug 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.