Basic Information
Provider Information
NPI: 1427494921
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ISLEY
FirstName: AARON
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1145 S UTICA AVE
Address2: STE 460
City: TULSA
State: OK
PostalCode: 741044000
CountryCode: US
TelephoneNumber: 9185795749
FaxNumber: 9185795762
Practice Location
Address1: 1145 S UTICA AVE
Address2: STE 460
City: TULSA
State: OK
PostalCode: 741044000
CountryCode: US
TelephoneNumber: 9185795749
FaxNumber: 9185795762
Other Information
ProviderEnumerationDate: 05/11/2013
LastUpdateDate: 06/20/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208M00000X5572OKY Allopathic & Osteopathic PhysiciansHospitalist 

ID Information
IDTypeStateIssuerDescription
200542040 B05OK MEDICAID


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