Individual
DR. JAY KEVIN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
802 S JACKSON AVE STE 420, TULSA, OK 74127-9059
(918) 743-2882
(918) 745-0323
Mailing address
5310 E 31ST ST FL 13, TULSA, OK 74135-5018
(918) 561-5701
(918) 561-1173
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
2533
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100137280B
—
OK
01
—
369701YM2Y
MEDICARE
OK
Enumeration date
07/27/2006
Last updated
12/15/2021
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