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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Sunday, December 22, 2024 3:49 AM CST
Next Update: Sunday, December 22, 2024 12:00 PM CST

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LONG, DAVID ALLAN II       
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: INTEGRIS EDMOND
4801 INTEGRIS PARKWAY
EDMOND OK 73134

Address last updated on 6/10/2024
Phone #: (405) 657-3000
Fax #: (405) 604-6277
County: OKLAHOMA
License: 20241
Dated: 7/10/1997
Expires: 7/1/2025
Training Issued: 7/1/1996
Training Expires: 8/1/1997
License Type: Medical Doctor
Specialty: Emergency 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: 6 / 1996
CME Year: 2027
Pending and/or Past Disciplinary Actions:
Date Action Reasons Remarks
12/2/2006 License Reinstated
11/2/2006 Suspension, License
6/26/2006 Complaint Citation
Board Filings and/or Orders:
11/02/2006
06/23/2006
06/23/2006
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Certifications: AMERICAN BOARD OF EMERGENCY MEDICINE
New Patients: Yes
Medicaid: Yes
Medicare: Yes
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
INTEGRIS EDMOND
4801 INTEGRIS PARKWAY
EDMOND OK 73134

Phone #: (405) 657-3000
Fax #: (405) 604-6277
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
KEVIN EDWIN BEAVER PA 2637
WADE MICHAEL BITTLE PA 1681
EMILY BOSHELL PA 3087
CHRISTOPHER TODD JAMES PA 1231
CATHERINE RENEE PAZOURECK PA 1723
DEBORAH BALLARD REED PA 1546
MANDI BROOKE RHODES PA 1836
JACK BRADLEY SMITH PA 1155

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