Provider Demographics
NPI:1013366913
Name:BARBER, JOHNATHAN WILLIAM (DPT)
Entity Type:Individual
Prefix:
First Name:JOHNATHAN
Middle Name:WILLIAM
Last Name:BARBER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5336 E 81ST ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-2224
Mailing Address - Country:US
Mailing Address - Phone:918-231-0488
Mailing Address - Fax:
Practice Address - Street 1:7401 RIVERSIDE PKWY UNIT 219
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-5057
Practice Address - Country:US
Practice Address - Phone:918-216-9303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-10
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5194225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist