Healthcare Provider Details

I. General information

NPI: 1790075034
Provider Name (Legal Business Name): JOHN KESLER EVANS D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2011
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11912 S NORWOOD AVE
TULSA OK
74137-5547
US

IV. Provider business mailing address

PO BOX 200
JENKS OK
74037-0200
US

V. Phone/Fax

Practice location:
  • Phone: 918-943-5303
  • Fax: 855-312-3594
Mailing address:
  • Phone: 918-943-5303
  • Fax: 855-312-3594

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number5210
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: