Individual
RICHARD ROBERT JESUDASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1725 E 19TH ST, STE 600, TULSA, OK 74104-4012
(918) 748-1330
(918) 293-3166
Mailing address
1145 S UTICA AVE, STE 701, TULSA, OK 74104-4019
(918) 832-6049
(918) 832-6055
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
20099
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100028320A
—
OK
Enumeration date
07/25/2006
Last updated
10/25/2017
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