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General NPI Number Information
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NPI Number | 1649565821
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Entity Type | Individual
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Provider Name | JOHN H KEPHART D.O.
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Gender | Male
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Dates
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Enumeration Date | 06/15/2011
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 5801 E. 41ST STREET SUITE 900
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City | TULSA
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State | OK
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Zip | 74135-5631
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Country | US
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Telephone | 918-934-8347
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Fax | 918-743-8552
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Provider Business Mailing Address
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Address Line | PO BOX 4930
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City | TULSA
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State | OK
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Zip | 74159-0930
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Country | US
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Telephone | 918-934-8347
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Fax | 918-743-8552
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OT014362
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 5761
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License Number State | OK
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