Basic Information
Provider Information
NPI: 1346509643
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HILL
FirstName: ERICA
MiddleName: LAINE
NamePrefix: MRS.
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6600 S YALE AVE STE 1200
Address2:  
City: TULSA
State: OK
PostalCode: 741363361
CountryCode: US
TelephoneNumber: 9184886045
FaxNumber: 9184886098
Practice Location
Address1: 6475 S YALE AVE STE 400
Address2:  
City: TULSA
State: OK
PostalCode: 74136
CountryCode: US
TelephoneNumber: 9185029600
FaxNumber: 9185029610
Other Information
ProviderEnumerationDate: 05/08/2012
LastUpdateDate: 08/23/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2086X0206X5390OKY Allopathic & Osteopathic PhysiciansSurgerySurgical Oncology

No ID Information.


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