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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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GANNON, PATRICK RUSSELL       
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: SOUTHEAST ORTHOPEDICS AT MRHC
1 CLARK BASS BLVD
MCALESTER OK 74501

Address last updated on 5/28/2024
Phone #: (918) 421-6753
Fax #: (918) 421-6758
County: PITTSBURG
License: 20652
Dated: 6/5/1998
Expires: 6/1/2025
License Type: Medical Doctor
Specialty: Orthopedic Surgery
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: YES
Medical School: Washington Univ in St Louis Sch of Med, St Louis MO
Graduated: 5 / 1993
CME Year: 2025
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 ORTHOPAEDIC SURGERY
New Patients: Yes
Medicaid: Yes
Medicare: Yes
   
HMO/PPO: Aetna PPO
BlueChoice PPO
HealthChoice
Preferred Community Choice
United Healthcare Options PPO
Welcor/Sooner
Hospital Privileges: McAlester Regional Health Center
McAlester, OK
Locations: Hours: Languages:
SOUTHEAST ORTHOPEDICS AT MRHC
1 CLARK BASS BLVD
MCALESTER OK 74501

Phone #: (918) 421-6753
Fax #: (918) 421-6758
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
MICHAEL EDWARD BAKER AT 133
JONATHAN PHILIP HERRICK AT 1238
RYAN ROBERT KNOERDEL PA 5035
LUKE BENJAMIN SCHUMACHER PA 2796
LAUREN WALLACE PA 4427

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