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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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MARTIN, ALAN LEE       
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: 4812 S. 109TH. E. AVE.
SUITE 200
TULSA OK 74146-5822

Address last updated on 6/7/2024
Phone #: (918) 236-4567
Fax #: (918) 236-4578
County: TULSA
License: 17399
Dated: 7/26/1990
Expires: 7/1/2025
Training Issued: 6/22/1989
Training Expires: 9/30/1990
License Type: Medical Doctor
Specialty: Rheumatology
MEDICINE/PEDIATRICS
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 / 1989
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 INTERNAL MEDICINE - Rheumatology
New Patients: Yes
Medicaid: No
Medicare: Yes
   
HMO/PPO: None listed
Hospital Privileges: Ascension St. John Hospital - Broken Arrow
Broken Arrow, OK
Ascension St. John Medical Center
Tulsa, OK
St. Francis Hospital
Tulsa, OK
Locations: Hours: Languages:
4812 S. 109TH. E. AVE.
SUITE 200
TULSA OK 74146-5822

Phone #: (918) 236-4567
Fax #: (918) 236-4578
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
MINDY DIANE EWERT PA 2666

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