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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Wednesday, December 18, 2024 6:43 PM CST
Next Update: Thursday, December 19, 2024 2:50 AM CST

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ELLIS, DAVID PAUL       
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: 15000 N DOUGLAS BLVD
JONES OK 73049-3447

Address last updated on 5/22/2024
Phone #: (405) 205-8717
Fax #: (405) 555-5555
County: OKLAHOMA
License: 15874
Dated: 7/1/1986
Expires: 7/1/2025
License Type: Medical Doctor
Specialty: Anesthesiology
Pain Management (Anesthesiology)
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of Ok Coll Of Med, Oklahoma City Ok 73190
Graduated: 6 / 1981
CME Year: 2027
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.
Certifications: AMERICAN BOARD OF ANESTHESIOLOGY
ABPS - Anesthesiology
New Patients: Yes
Medicaid: Yes
Medicare: Yes
   
HMO/PPO: Aetna Elect Choice
Aetna HMO
Aetna Managed Choice
Aetna PPO
Blue Cross Blue Shield-Blue Preferred
Blue Cross Blue Shield-Blue Traditional
Blue Cross Blue Shield-Plan 65 Select
BlueChoice PPO
BlueLincs HMO
Champ VA
CIGNA PPO
Coventry Health Care National Network
Evolutions Healthcare
First Health
Global Health HMO
Great West Healthcare
HealthChoice
Humana ChoiceCare
Humana Medicare Advantage PPO
Humana Tricare/PGBA
Medicare Blue
Multiplan PPO
OSMA Health (formerly Plico PPO)
Pacificare Commercial HMO
PacifiCare of Oklahoma, Inc
PHCS (Private Healthcare Systems)
PPO USA
Preferred Community Choice
Private Healthcare Systems (PHCS)
Railroad Medicare
Secure Horizons HMO
SoonerCare HMO
Tricare for Life
Tricare Standard
United Healthcare Choice
United Healthcare EPO
United Healthcare HMO
United Healthcare Options PPO
United Healthcare POS
Hospital Privileges: None listed
Locations: Hours: Languages:
15000 N DOUGLAS BLVD
JONES OK 73049-3447

Phone #: (405) 205-8717
Fax #: (405) 555-5555
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
AMBER MICHELLE DRENNEN PA 1951
JESSICA MARIE WELLS-BURRIS PA 2102

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