Active NPI
Jeesoo Daniel Kang, DO
- Internal Medicine Physician
- Tahlequah, OK
National Provider Identifier
1932095783
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 207R00000X
- Practice address
- 1400 E Downing St
Tahlequah, OK 74464-3324 - Phone
- (918) 456-0641
- NPI assigned
- Jun 17, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 207R00000X | OK | Primary |
Addresses
Primary practice location
1400 E Downing St
Tahlequah, OK 74464-3324
Mailing address
113 South Logan Drive
Tahlequah, OK 74464
Phone (817) 394-8816
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 207R00000X | OK | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1750118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750118400000",
"number": "1932095783",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "113 SOUTH LOGAN DRIVE",
"city": "TAHLEQUAH",
"state": "OK",
"postal_code": "74464",
"telephone_number": "817-394-8816"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 E DOWNING ST",
"city": "TAHLEQUAH",
"state": "OK",
"postal_code": "744643324",
"telephone_number": "918-456-0641"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KANG",
"first_name": "JEESOO",
"middle_name": "DANIEL",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-06-17",
"last_updated": "2025-06-17",
"certification_date": "2025-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OK",
"license": "207R00000X",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tahlequah, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.