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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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BOOTH, KELEY JOHN       
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: 13100 N. WESTERN AVE
SUITE 303
OKLAHOMA CITY OK 73114

Address last updated on 2/29/2024
Phone #: (800) 781-1220
Fax #: (888) 678-8616
County: OKLAHOMA
License: 22940
Dated: 3/23/2004
Expires: 3/1/2025
License Type: Medical Doctor
Specialty: Anesthesiology
Pain Management (Anesthesiology)
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: 5 / 2002
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 ANESTHESIOLOGY
New Patients: Yes
Medicaid: No
Medicare: Yes
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
13100 N. WESTERN AVE
SUITE 303
OKLAHOMA CITY OK 73114

Phone #: (800) 781-1220
Fax #: (888) 678-8616
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:
11401 S. WESTERN AVE
Oklahoma City, OK 73170

Phone #: (800) 781-1220
Fax #: (10) 201-1
Mon:
Tue:
Wed:
Thu:
Fri: 9:00AM - 5:00PM
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Sun:
4200 Carriage Way
Weatherford, OK 73096

Phone #: (800) 781-1220
Fax #: (4) 201-
Mon:
Tue:
Wed:
Thu: 9:00AM - 4:00PM
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Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
ZACKERY RYAN DEVINE PA 4394
LEE RICHERSON MACKIN PA 5062
MISTI MOON-HARRIS APRN 73220
ASHTON TYLER ROBERTSON PA 2918

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