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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Monday, December 23, 2024 1:13 PM CST
Next Update: Monday, December 23, 2024 4:30 PM CST

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ROTHER, JEFFREY ALAN       
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: 1020 NORTH COMMERCE
ARDMORE OK 73401

Address last updated on 11/3/2024
Phone #: (580) 224-2900
Fax #: (580) 220-6429
County: CARTER
License: 17679
Dated: 7/1/1991
Expires: 7/1/2025
Training Issued: 6/21/1990
Training Expires: 7/1/1991
License Type: Medical Doctor
Specialty: Pediatrics
Internal Medicine
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 / 1990
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:
New Patients: Yes
Medicaid: No
Medicare: Yes
   
HMO/PPO: Aetna PPO
BlueChoice PPO
HealthChoice
Preferred Community Choice
United Healthcare Options PPO
Hospital Privileges: Mercy Memorial Health Center, Inc. - Ardmore
Ardmore, OK
Locations: Hours: Languages:
1020 NORTH COMMERCE
ARDMORE OK 73401

Phone #: (580) 224-2900
Fax #: (580) 220-6429
Mon: 8:30AM - 5:00PM
Tue: 8:30AM - 5:00PM
Wed: 8:30AM - 5:00PM
Thu: 8:30AM - 5:00PM
Fri: 8:30AM - 5:00PM
Sat:
Sun: 8:30AM - 5:00PM
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
JERRI LYNN BRADSHAW PA 1402
MELISSA HALLUM APRN 92696
PHILLIP HATLEY APRN 220
ABBIE MCLEMORE APRN 113722
HEATHER MOISER APRN 78547
MICHAEL TALKINGTON APRN 83276
BRADLEY TAYLOR PA 4463

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