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Oklahoma Board of Medical Licensure and Supervision

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Next Update: Saturday, December 21, 2024 12:00 PM CST

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TANNER, RUSSELL EDWARD       
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: 4021 NEPTUNE DRIVE
OKLAHOMA CITY OK 73116-1659

Address last updated on 8/14/2013
Phone #: (405) 787-1700
Fax #:
County: OKLAHOMA
License: 20317
Dated: 10/22/1997
Expires: 10/1/2017
License Type: Medical Doctor
Specialty: Obstetrics & Gynecology
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: Wayne State Univ SOM, Detroit Mi 48201
Graduated: 6 / 1977
CME Year: 2018
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: Contact licensee
Medicaid: Yes
Medicare: Yes
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
4021 NEPTUNE DRIVE
OKLAHOMA CITY OK 73116-1659

Phone #: (405) 787-1700
Fax #:
Mon: 8:00AM - 5:00PM
Tue: 8:00AM - 5:00PM
Wed: 8:00AM - 5:00PM
Thu: 8:00AM - 5:00PM
Fri: 8:00AM - 5:00PM

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