Kenny Susanto is a Tulsa, Oklahoma based neurologist with 13 years of experience in Neurology. He completed his graduation in 2012. He accepts the Medicare-approved amount. Patients will not be billed for any more than the Medicare deductible and coinsurance. Active license number of Kenny Susanto is 38794 for Neurology in Oklahoma. His current practice location is 2000 S Wheeling Ave Ste 701, Tulsa. Patients can reach him at 918-748-7810. Kenny Susanto is MD in Neurology and his NPI number (Unique professional ID assigned by NPPES) is 1255783270.
Kenny Susanto specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.
Complete Profile:
Kenny Susanto speciality, credentials, practice address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointment.
| Name: | Kenny Susanto |
| Specialization: | Neurology |
| Gender: | Male |
| Credentials: | MD |
| Experience: | 13+ years |
| Medical School Attended: | Other |
| Graduation Year: | 2012 |
| Accepts Medicare Assignment: | Yes |
| Practice Address: | 2000 S Wheeling Ave Ste 701, Tulsa,
Oklahoma, 74104-5647 |
| Phone: | 918-748-7810 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| PAC ID: | 1254758410 |
| Enrollment ID: | I20220815001112 |
| NPI Number: | 1255783270 |
| NPI Enumeration Date: | 02 Jul, 2016 |
| NPI Last Update On: | 27 Jun, 2022 |
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Kenny Susanto are as mentioned below.
| License Number | Specialization | State | Status | |
| 38794 | Neurology | Oklahoma | Primary | |
| 1.065004 | Neurology | Connecticut | Secondary | |
| 008863 | Neurology | Georgia | Secondary | |
Group Practice:
Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name
with which Kenny Susanto is associated with along with the number of members in that group.
| Organization Name (Group PAC ID) | Members |
| St John Physicians Inc (2567366495) | 234 |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Kenny Susanto
2000 S Wheeling Ave Ste 701,
Tulsa, Oklahoma |
| Zip: | 74104-5647 |
Patients can reach Kenny Susanto at
2000 S Wheeling Ave Ste 701, Tulsa, Oklahoma or can
call to book an appointment on 918-748-7810.
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Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 13 October, 2025.