Basic Information
Provider Information
NPI: 1659322378
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CANFIELD
FirstName: VIKKI
MiddleName: ANN
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4401 W MEMORIAL RD
Address2: 140
City: OKLAHOMA CITY
State: OK
PostalCode: 731341785
CountryCode: US
TelephoneNumber: 4057523162
FaxNumber: 4059365211
Practice Location
Address1: 4205 MCAULEY BLVD
Address2: 375
City: OKLAHOMA CITY
State: OK
PostalCode: 731209391
CountryCode: US
TelephoneNumber: 4057514343
FaxNumber: 4057514346
Other Information
ProviderEnumerationDate: 05/15/2006
LastUpdateDate: 04/22/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RH0003X17952OKY Allopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology

No ID Information.


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