Healthcare Provider Details

I. General information

NPI: 1922323146
Provider Name (Legal Business Name): JOHN MARK WEBER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2010
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6151 S YALE AVE STE 1304
TULSA OK
74136-1907
US

IV. Provider business mailing address

6600 S YALE AVE STE 1200
TULSA OK
74136-3333
US

V. Phone/Fax

Practice location:
  • Phone: 918-502-3200
  • Fax: 918-502-3205
Mailing address:
  • Phone: 888-247-0125
  • Fax: 918-502-8210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number30899
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: