Provider Demographics
NPI:1285703249
Name:OHENHEN, JONATHAN (MD)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:
Last Name:OHENHEN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:921 W 11TH ST
Mailing Address - Street 2:STE 2
Mailing Address - City:SULPHUR
Mailing Address - State:OK
Mailing Address - Zip Code:73086-4459
Mailing Address - Country:US
Mailing Address - Phone:580-622-2353
Mailing Address - Fax:580-622-2351
Practice Address - Street 1:921 W 11TH ST
Practice Address - Street 2:STE 2
Practice Address - City:SULPHUR
Practice Address - State:OK
Practice Address - Zip Code:73086-4459
Practice Address - Country:US
Practice Address - Phone:580-622-2353
Practice Address - Fax:580-622-2351
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK23001207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine