Luster I. Jacobs, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

12716 Issued in OK

Practice address

6161 S Yale Ave
ER Dept
Tulsa, OK 74136-1902

Phone

(918) 494-6528

Fax

(405) 749-4561

NPI assigned

Apr 27, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211846400000",
    "number": "1619934221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22063",
            "address_2": "DEPT 0491",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741212063",
            "telephone_number": "405-751-4664",
            "fax_number": "405-749-4561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6161 S YALE AVE",
            "address_2": "ER DEPT",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741361902",
            "telephone_number": "918-494-6528",
            "fax_number": "405-749-4561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "LUSTER",
        "middle_name": "I.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2008-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "12716",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100108940C",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William L Jackson Jr., MD
• William Landon Jackson, DO
• Andrew Nathan Jacob
• Hayden Riley Jacobs, DO, MPH, CPH
• Lois I Jacobs, DDS
• Siara Jacobs
• Talitha Jacobs, RRT
• Britni Leigh Jacobson
• Katye Jacobson
• Ryan Jacobson

• Emergency Medicine Physician in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Emergency Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.