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NPI Code Detail

MEDICARE: JONATHAN ISENBERG DO

MEDICARE: JONATHAN ISENBERG DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2207P00000XEmergency Medicine Physician9114OK

General Provider Information

NPI Number : 1255185740
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONATHAN ISENBERG DO
Provider Business Mailing Address
First Line : 4502 E 41ST ST
Second Line :
City : TULSA
State : OK
Zip : 74135-2536
Country : US
Telephone Number : 918-579-2367
Fax Number :
Provider Business Practice Location Address
First Line : 4502 E 41ST ST
Second Line :
City : TULSA
State : OK
Zip : 74135-2536
Country : US
Telephone Number : 918-579-2367
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2024
Last Update Date : 01/21/2026

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Directions to “ JONATHAN ISENBERG DO” Practice Location

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