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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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WIENECKE, GRETCHEN MILLER       
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: OKLAHOMA SPINE HOSPITAL PAIN MANAGEMENT
14100 PARKWAY COMMONS
SUITE 102
OKLAHOMA CITY OK 73134

Address last updated on 8/6/2024
Phone #: (405) 749-2765
Fax #: (405) 749-6209
County: OKLAHOMA
License: 20186
Dated: 9/11/1997
Expires: 9/1/2025
License Type: Medical Doctor
Specialty: Pain Management (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: 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 ANESTHESIOLOGY
AMERICAN BOARD OF ANESTHESIOLOGY - Pain Medicine
New Patients: Yes
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: OU Health - Edmond (frmrly Edmond Medical Center)
Edmond, OK
OU Health Medical Center
Oklahoma City, OK
Locations: Hours: Languages:
OKLAHOMA SPINE HOSPITAL PAIN MANAGEMENT
14100 PARKWAY COMMONS
SUITE 102
OKLAHOMA CITY OK 73134

Phone #: (405) 749-2765
Fax #: (405) 749-6209
Mon: 7:00AM - 4:00PM
Tue: 7:00AM - 4:00PM
Wed: 7:00AM - 4:00PM
Thu: 7:00AM - 4:00PM
Fri:
Sat:
Sun:
OU HEALTH PAIN MEDICINE 825 NE 10TH ST
SUITE 2B
OKLAHOMA CITY, OK 73104

Phone #: (405) 271-7255
Fax #: (1) 200-5
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
KELLY MICHELLE COOPER PA 874

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