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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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CARNINE, THADDEUS ALAN       
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: 2017 I-35 W. FRONTAGE RD
SUITE 250
EDMOND OK 73013

Address last updated on 10/29/2024
Phone #: (405) 757-3340
Fax #:
County: OKLAHOMA
License: 22939
Dated: 11/21/2002
Expires: 11/1/2025
License Type: Medical Doctor
Specialty: Orthopedic Surgery
Sports Medicine (Orthopedic Surgery)
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 / 2001
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 ORTHOPAEDIC SURGERY
AMERICAN BOARD OF ORTHOPAEDIC SURGERY - Orthopaedic Sports Medicine
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: INTEGRIS Baptist Medical Center
Oklahoma City, OK
INTEGRIS Canadian Valley Regional Hospital
Yukon, OK
INTEGRIS Edmond
Edmond, OK
Locations: Hours: Languages:
2017 I-35 W. FRONTAGE RD
SUITE 250
EDMOND OK 73013

Phone #: (405) 757-3340
Fax #:
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
BRANDON SCOTT FUNK PA 1465
KACI BROOKE JUENGEL PA 2985

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