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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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ELLIOTT, MICHAEL STEPHEN
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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.
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| Practice Address: |
MERCY CLINIC EDMOND WATERLOO
301 EAST WATERLOO ROAD
EDMOND OK 73034
Address last updated on 6/13/2022 |
| Phone #: |
(405) 715-2000 |
| Fax #: |
(405) 715-2010 |
| County: |
OKLAHOMA |
| License: |
19806 |
| Dated: |
7/11/1996 |
| Expires: |
7/1/2025 |
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Training
Issued:
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7/6/1995 |
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Training
Expires:
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8/1/1996 |
| License Type: |
Medical Doctor |
| Specialty: |
Internal Medicine/Pediatrics |
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| Status: |
Active |
| Status Class: |
Fully Licensed |
| Restricted to: |
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| Registered to Dispense: |
YES |
| Medical School: |
Univ Of Ok Coll Of Med, Oklahoma City Ok 73190 |
| Graduated: |
6 /
1995 |
| CME Year: |
2027 |
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Pending and/or Past Disciplinary Actions:
No Disciplinary Action Taken.
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All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
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| Certifications: |
AMERICAN BOARD OF INTERNAL MEDICINE
AMERICAN BOARD OF PEDIATRICS |
| New Patients: |
No |
| Medicaid: |
No |
| Medicare: |
Yes |
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| HMO/PPO: |
None listed |
| Hospital Privileges: |
Mercy Hospital Logan County (fmly Logan Hosp. and MC)
Guthrie, OK
Mercy Hospital OKC
Oklahoma City, OK
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Primary Supervisees(s):
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| Name: |
Type: |
License Number: |
Full/Part Time: |
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KYLE NATHAN LIPKE
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PA |
1667 |
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