Organization · Type 2 NPI

Oklahoma Cancer Specialists and Research Institute LLC

MOHS-Micrographic Surgery Physician · Broken Arrow, OK

NPI number 1104291236 Active

Practice location

800 W Boise Cir Ste 400
Broken Arrow, OK 74012-4974

Fax (918) 250-7669

Mailing address

12697 E 51st St
Tulsa, OK 74146-6236

Specialties and licenses

TaxonomyCodeLicense
MOHS-Micrographic Surgery Physician Primary 207ND0101XNone listed
Procedural Dermatology Physician 207NS0135XNone listed

MOHS-Micrographic Surgery Physician: The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one…

Another provider at this address

About NPI 1104291236

Oklahoma Cancer Specialists and Research Institute LLC's National Provider Identifier is 1104291236, issued on Dec 1, 2015. The primary taxonomy on file is MOHS-Micrographic Surgery Physician (207ND0101X), and the practice location is in Broken Arrow, OK. The record was last updated on Aug 11, 2025.