C. MICHAEL JOHNSON, D.O,INC. (NPI# 1679746895) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679746895 |
| Entity Type | Organization |
| Organization Name | C. MICHAEL JOHNSON, D.O,INC. |
| Practice Address |
802 S Jackson Ave Suite 110 Tulsa OK 74127-9015 |
| Mailing Address |
802 So. Jackson Ave Suite 110 Tulsa OK 74127-8921 |
| Practice Telephone | 9185872389 |
| Practice Fax Number | 9185874389 |
| Mailing Telephone | 9185872389 |
| Mailing Fax Number | 9185874389 |
| Enumeration Date | 2008-04-09 |
| Last Update Date | 2008-11-18 |
| Authorized Official Name | MRS. SUSIE MONROE (OFFICE MANAGER) |
| Authorized Official Telephone | 9185872389 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 1716 | OK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 100088070 A | 05 |
| Street Address |
802 S JACKSON AVE SUITE 110 |
| City | TULSA |
| State | OK |
| Zip Code | 74127-9015 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972564169 | Daniel A Nader | Internal Medicine | 802 S Jackson Ave, Tulsa, OK 74127-9015 | 2006-03-29 |
| 1346784683 | Osu Cardiology | Internal Medicine | 802 S Jackson Ave, Suite 225, Tulsa, OK 74127-9015 | 2016-12-06 |
| 1629437546 | Bret Colter Haines | Surgery | 802 S Jackson Ave, Suite 505, Tulsa, OK 74127-9015 | 2016-02-19 |
| 1902262421 | Lp Dullye Management, Inc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 802 S Jackson Ave, Suite 200, Tulsa, OK 74127-9015 | 2016-01-13 |
| 1922491935 | Osu Center for Health Sciences | Clinic/Center | 802 S Jackson Ave, Suite 210, Tulsa, OK 74127-9015 | 2015-03-16 |
| 1144650854 | Osu Center for Health Sciences | Clinic/Center | 802 S Jackson Ave, Suite 210, Tulsa, OK 74127-9015 | 2013-11-15 |
| 1467748467 | Osu Center for Health Sciences | Clinic/Center | 802 S Jackson Ave, Suite 312, Tulsa, OK 74127-9015 | 2011-06-28 |
| 1548556541 | Osu Center for Health Sciences | Clinic/Center | 802 S Jackson Ave, Suite 110, Tulsa, OK 74127-9015 | 2011-06-28 |
| 1790076222 | Adam Derek Bradley | Surgery | 802 S Jackson Ave, #505, Tulsa, OK 74127-9015 | 2011-05-02 |
| 1013238872 | Osu Center for Health Sciences | Clinic/Center | 802 S Jackson Ave, Suite 400, Tulsa, OK 74127-9015 | 2010-06-16 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366966699 | Tarell Lynell Earl | Case Manager/Care Coordinator | 602 N. 28th W. Pl., Tulsa, OK 74127 | 2017-07-28 |
| 1023538014 | Milton Dean IIi | Counselor | 1234 N Rosedale, Tulsa, OK 74127 | 2017-06-21 |
| 1740700988 | Lisa Lee Ann Gilliland | Case Manager/Care Coordinator | 2001 W Ute Pl, Tulsa, OK 74127 | 2017-06-20 |
| 1114456498 | Kevin Thomas Jackson | Counselor | 310 S 49th W Ave, Tulsa, OK 74127 | 2017-06-08 |
| 1427406180 | Byron Conrad Dixon Jr. | Case Manager/Care Coordinator | 551 N. 28th W. Ave., Tulsa, OK 74127 | 2016-06-02 |
| 1548621568 | Brandon Worth | Student in an Organized Health Care Education/Training Program | 717 S. Houston Ave., Suite 400, Tulsa, OK 74127 | 2016-03-18 |
| 1073987467 | Jo Lowe | Social Worker | 420 S. Lawton Ave. Apt 315, Tulsa, OK 74127 | 2015-11-23 |
| 1154718575 | William Hughes | Health Educator | 3101 W Edison, Tulsa, OK 74127 | 2015-04-23 |
| 1801289665 | Kristyn Janelle Zrenda | Student in an Organized Health Care Education/Training Program | 717 S. Houston Ave., Suite 400, Tulsa, OK 74127 | 2015-03-17 |
| 1831595719 | Mallory Yarbrough | Counselor | 3005 N 24th West Ave, Tulsa, OK 74127 | 2014-11-05 |
| Find all providers in zip 74127 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003159773 | Philip D. Diggdon Sr. | Urology | 3424 E. 65 St, Tulsa, OK 74136 | 2013-04-01 |
| 1811247885 | Melanie Nyeh Ketchandji | Urology | 1145 South Utica Avenue, Suite 202, Tulsa, OK 74104-4022 | 2012-09-17 |
| 1184818551 | Sunshine Murray | Urology | 10901 E. 48th Street S., Tulsa, OK 74146-5830 | 2007-08-29 |
| 1588685093 | Michael Burwell Smith | Urology | 10901 E 48 St S, Tulsa, OK 74146 | 2006-07-21 |
| 1013937911 | Bruce Carlton Stoesser | Urology | 10901 E 48th St S, Tulsa, OK 74146-5830 | 2006-07-20 |
| 1013983741 | Kevin Joseph Gancarczyk | Urology | 10901 E 48th St, Tulsa, OK 74146-5830 | 2006-02-23 |
| 1912978511 | Curtis Ryan Powell | Urology | 10901 E. 48th St. S., Tulsa, OK 74146-5830 | 2006-01-31 |
| 1750380085 | Thomas W. Rickner | Urology | 6585 S Yale Ave, Suite 720, Tulsa, OK 74136-8384 | 2005-07-19 |
| 1992068829 | Logan Campbell | Urology | 6585 S Yale Ave Ste 720, Tulsa, OK 74136 | 2012-06-15 |
| 1215299284 | Nora Baker | Urology | 6585 S Yale Ave Ste 720, Tulsa, OK 74136-8320 | 2012-06-14 |
| Find all providers in TULSA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.