EASTERLY, PHILLIP WILLIAM - Licensee Information

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Last Update: Sunday, December 22, 2024 6:44 PM CST
Next Update: Monday, December 23, 2024 2:50 AM CST

EASTERLY, PHILLIP WILLIAM

This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.

Practice Address:	138TH AIR FORCE NATIONAL GUARD 9100 E 46TH ST N TULSA OK 74115 Address last updated on 10/16/2024
Phone #:	(580) 541-6093
Fax #:
County:	TULSA
License:	713
Dated:	9/13/2012
Expires:	8/31/2025
License Type:	Athletic Trainer
Specialty:

Status:	Active
Status Class:	Fully Licensed
Restricted to:
CME Year:	0

Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.

All information below is entered by the licensee but not verified by the Oklahoma Medical Board.

Locations:	Hours:	Languages:
138TH AIR FORCE NATIONAL GUARD 9100 E 46TH ST N TULSA OK 74115 Phone #: (580) 541-6093 Fax #:

Name:	Type:	License Number:	Full/Part Time:
Primary Supervisor(s):
JASON MATTHEW LEINEN	MD	25158

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