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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Monday, December 23, 2024 3:49 AM CST
Next Update: Monday, December 23, 2024 12:00 PM CST

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PRUITT, JEFFERY RANDALL       
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: MERCY HOSPITALISTS
4300 W MEMORIAL RD
EDMOND OK 73120

Address last updated on 1/27/2022
Phone #: (405) 752-3962
Fax #: (405) 752-3963
County: OKLAHOMA
License: 23454
Dated: 3/8/2005
Expires: 3/1/2025
License Type: Medical Doctor
Specialty: Hospitalist
Internal Medicine
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 / 2003
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 INTERNAL MEDICINE
AMERICAN BOARD OF INTERNAL MEDICINE (Focused Practice in Hospital Medicine)
New Patients: Contact licensee
Medicaid: Yes
Medicare: Yes
   
HMO/PPO: None listed
Hospital Privileges: Mercy Hospital OKC
Oklahoma City, OK
Locations: Hours: Languages:
MERCY HOSPITALISTS
4300 W MEMORIAL RD
EDMOND OK 73120

Phone #: (405) 752-3962
Fax #: (405) 752-3963
Mon: 6:00AM - 5:45AM
Tue: 6:00AM - 5:45AM
Wed: 6:00AM - 5:45AM
Thu: 6:00AM - 5:45AM
Fri: 6:00AM - 5:45AM
Sat: 6:00AM - 5:45AM
Sun: 6:00AM - 5:45AM
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
NONI CHAU PA 4948
LORI HENDERSON APRN 16735
KRYSTEN LYNN JENKINS PA 2328
BROOKE ELLEN PELTON PA 5182
UYEN KIM PHAM PA 2735
BARBARA STEPHEN APRN 74467

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