Healthcare Provider Details

I. General information

NPI: 1538072186
Provider Name (Legal Business Name): JOHN BROTHERS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

OU SCHOOL OF COMMUNITY MEDICINE 4444 EAST 41ST ST
TULSA OK
74135
US

IV. Provider business mailing address

OU SCHOOL OF COMMUNITY MEDICINE 4444 EAST 41ST ST
TULSA OK
74135
US

V. Phone/Fax

Practice location:
  • Phone: 918-619-4400
  • Fax:
Mailing address:
  • Phone: 918-619-4400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: