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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Thursday, December 19, 2024 3:44 AM CST
Next Update: Thursday, December 19, 2024 12:00 PM CST

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FULLER, BENNETT EVAN       
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: 13321 N. MERIDIAN AVE.
SUITE #402
OKLAHOMA CITY OK 73120-8316

Address last updated on 6/5/2024
Phone #: (405) 755-1080
Fax #: (405) 751-8923
County: OKLAHOMA
License: 16252
Dated: 7/22/1987
Expires: 7/1/2025
License Type: Medical Doctor
Specialty: 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: 5 / 1986
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
New Patients: Yes
Medicaid: Yes
Medicare: Yes
   
HMO/PPO: None listed
Hospital Privileges: Mercy Hospital OKC
Oklahoma City, OK
Oklahoma Spine Hospital
Oklahoma City, OK
Oklahoma Surgicare
Oklahoma City, OK
Locations: Hours: Languages:
13321 N. MERIDIAN AVE.
SUITE #402
OKLAHOMA CITY OK 73120-8316

Phone #: (405) 755-1080
Fax #: (405) 751-8923
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
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