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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Friday, November 22, 2024 8:19 AM CST
Next Update: Friday, November 22, 2024 12:00 PM CST

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RODRIGUEZ, ORSON PABUSTAN       
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: 1380 W COVELL RD
SUITE 132
EDMOND OK 73033

Address last updated on 4/18/2024
Phone #: (405) 400-9442
Fax #: (405) 429-8041
County: OKLAHOMA
License: 23389
Dated: 6/1/2005
Expires: 6/1/2025
License Type: Medical Doctor
Specialty: Family Medicine
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of Santo Tomas, Fac Of Med And Surg, Manila, Philippines
Graduated: 4 / 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: None listed
Hospital Privileges: Hospital Not Listed
,
Locations: Hours: Languages:
1380 W COVELL RD
SUITE 132
EDMOND OK 73033

Phone #: (405) 400-9442
Fax #: (405) 429-8041
Mon: 8:00AM - 8:00PM
Tue: 8:00AM - 8:00PM
Wed: 8:00AM - 8:00PM
Thu: 8:00AM - 8:00PM
Fri: 8:00AM - 8:00PM
Sat: 8:00AM - 8:00PM
Sun: 9:00AM - 5:00PM
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
PAUL COOPER APRN 100353
MELINDA KRUGER APRN 106037
MEGAN ELIESE MITCHELL PA 2230
KRISTEN ROSENAU APRN 90610
CAROL ELIAS SINIARD PA 1888
LAURI STUCKI APRN 67460
KATHRYN WALENZ PA 2588

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