Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jacob Leon Callison, PA

Individual provider Physician Assistant · NPI 1487885877

Jacob Leon Callison, PA is a Physician Assistant in Broken Arrow, Oklahoma. Licensed in Oklahoma. Registered with an NPI since 2009.

Licensed in
OK
In the registry since
2009
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

5050 E Kenosha St
Broken Arrow, OK 74014-6711
Phone: (918) 994-5140
Fax: (918) 994-5150
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 1844 (OK)

Record details

NPI number1487885877
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedAugust 3, 2009
Last updated in NPPESOctober 8, 2024
Certification dateOctober 8, 2024
Mailing address5050 E Kenosha St, Broken Arrow, OK 74014-6711

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