Individual
JOHN MICHAEL NEISEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
6161 S YALE AVE, TULSA, OK 74136-1992
(918) 494-1805
(918) 494-4573
Mailing address
6600 S YALE AVE STE 1400, TULSA, OK 74136-3331
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
4613
OK
Other
Enumeration date
06/07/2021
Last updated
07/19/2022
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