Organization
ST. JOHN PHYSICIANS, INC.
Active
Parent organization
ST. JOHN PHYSICIANS, INC.
Other names
SJC Outpatient Diabetes Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST. JOHN PHYSICIANS, INC.
Authorized official
JAMES BRYAN FISSEL (DIRECTOR CHIEF FINANCIAL OFFICER)
(918) 748-7617
Entity
Organization
Contact information
Practice address
1717B S UTICA AVE STE 205, TULSA, OK 74104-5332
(918) 744-2444
(918) 744-2483
Mailing address
1923 S UTICA AVE # DT1000, TULSA, OK 74104-6520
(918) 744-2630
(918) 744-2946
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
163W00000X
Registered Nurse
—
—
163WD0400X
Diabetes Educator Registered Nurse
—
—
Other
Enumeration date
04/04/2018
Last updated
04/04/2018
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