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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Monday, December 23, 2024 3:49 AM CST
Next Update: Monday, December 23, 2024 12:00 PM CST

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CANNON, MICHAEL BRUCE       
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: 3500 HEALTHPLEX PARKWAY
SUITE 202
NORMAN OK 73072

Address last updated on 5/23/2024
Phone #: (405) 515-2222
Fax #: (405) 307-5715
County: CLEVELAND
License: 17716
Dated: 7/1/1991
Expires: 7/1/2025
Training Issued: 6/28/1990
Training Expires: 7/1/1991
License Type: Medical Doctor
Specialty: SURGERY, CARDIOVASCULAR
SURGERY, THORACIC
General Surgery
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 / 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: AMERICAN BOARD OF THORACIC SURGERY
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: Oklahoma Heart Hospital - North Campus (4050 W. Memorial Rd)
Oklahoma City, OK
Oklahoma Heart Hospital - South Campus (5200 I-240 Service Rd)
Oklahoma City, OK
Locations: Hours: Languages:
3500 HEALTHPLEX PARKWAY
SUITE 202
NORMAN OK 73072

Phone #: (405) 515-2222
Fax #: (405) 307-5715
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
KAILEE ANDERSON APRN 101250
PARKER BON MARTIN PA 2539
CHAD LEE NICHOLS PA 990
BRITTNEY JOLENE ROBERTS PA 2984
TRACEY WALKER APRN 56064

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