Individual
BARRY R EISEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1725 E 19TH ST, STE 600, TULSA, OK 74104-5424
(918) 749-3939
(918) 748-7548
Mailing address
1725 E 19TH ST, STE 600, TULSA, OK 74104-5424
(918) 749-3939
(918) 748-7548
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
13104
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020020933
RAILROAD MEDICARE
OK
05
—
10011920A
—
OK
Enumeration date
12/28/2005
Last updated
11/05/2012
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