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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Friday, November 22, 2024 6:42 PM CST
Next Update: Saturday, November 23, 2024 2:50 AM CST

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RADER, ROBERT WILLIAM       
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: 201 S. SARA ROAD
SUITE 200
MUSTANG OK 73064

Address last updated on 5/22/2024
Phone #: (405) 578-3250
Fax #:
County: OKLAHOMA
License: 21263
Dated: 7/7/1999
Expires: 7/1/2025
Training Issued: 7/1/1998
Training Expires: 8/1/1999
License Type: Medical Doctor
Specialty: Family Medicine
Hospitalist
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: YES
Medical School: Univ Of Ok Coll Of Med, Oklahoma City Ok 73190
Graduated: 6 / 1998
CME Year: 2026
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 FAMILY MEDICINE
New Patients: Yes
Medicaid: Yes
Medicare: Yes
   
HMO/PPO: Aetna HMO
Aetna PPO
Blue Cross Blue Shield-Blue Preferred
Blue Cross Blue Shield-Blue Traditional
Blue Cross Blue Shield-Plan 65 Select
BlueChoice PPO
BlueLincs HMO
CIGNA PPO
CommunityCare HMO, Inc
CommunityCare Senior HMO
First Health
Global Health HMO
HealthChoice
Humana ChoiceCare
Humana Medicare Advantage PPO
PacifiCare of Oklahoma, Inc
Preferred Community Choice
Prudential Health Care Plan, Inc
UniCare Health Plans of Oklahoma
United Healthcare HMO
United Healthcare Options PPO
Hospital Privileges: Northwest Surgical Hospital
Oklahoma City, OK
SSM Health Bone and Joint Hospital at St. Anthony
Oklahoma City, OK
SSM Health St. Anthony Hospital - OKC
Oklahoma City, OK
Locations: Hours: Languages:
201 S. SARA ROAD
SUITE 200
MUSTANG OK 73064

Phone #: (405) 578-3250
Fax #:
Mon:
Tue:
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1616 East Highway 152
Mustang, OK 73064

Phone #: (405) 384-6503
Fax #: (6) 201-
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Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
CAMBER CLINE APRN 88840
RALPH EUGENE FOUNTAIN PA 498
LINDEE RENAE LEDBETTER PA 1824
TIMOTHY ELLIOT LEGG PA 3169
STEVE MANFRED MADRID PA 870
JANA NIKOLE MORRIS PA 1383
HINAKUMARI D REY PA 2889
NICHOLAS TYLER RUSSENBERGER PA 5175
ALYSIA MOTA SMITH PA 4487
JENNIFER SPARKS APRN 5506
LYNNETTA STOUT APRN 94046
SARAH ELIZABETH THOMPSON PA 1988

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