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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Thursday, December 19, 2024 3:44 AM CST
Next Update: Thursday, December 19, 2024 12:00 PM CST

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GRIM, STEPHANIE CARLETON       
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: 3330 NW 56TH
SUITE 400
OKLAHOMA CITY OK 73112

Address last updated on 3/8/2024
Phone #: (405) 945-4220
Fax #: (405) 945-4893
County: OKLAHOMA
License: 23471
Dated: 5/19/2005
Expires: 5/1/2025
License Type: Medical Doctor
Specialty: Pediatrics
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: 6 / 2002
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 PEDIATRICS
New Patients: Yes
Medicaid: Yes
Medicare: No
   
HMO/PPO: None listed
Hospital Privileges: INTEGRIS Baptist Medical Center
Oklahoma City, OK
Lakeside Women's Hospital
Oklahoma City, OK
Mercy Hospital OKC
Oklahoma City, OK
Locations: Hours: Languages:
3330 NW 56TH
SUITE 400
OKLAHOMA CITY OK 73112

Phone #: (405) 945-4220
Fax #: (405) 945-4893
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
AUDREY GRACE MCGOWEN PA 2591

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