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Oklahoma Board of Medical Licensure and Supervision

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Next Update: Monday, December 23, 2024 2:50 AM CST

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BONNER, MATTHEW RAY       
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: 3300 NW EXPRESSWAY
OKLAHOMA CITY OK 73112

Address last updated on 3/5/2023
Phone #: (405) 949-4029
Fax #:
County: OKLAHOMA
License: 24385
Dated: 5/2/2005
Expires: 5/1/2025
License Type: Medical Doctor
Specialty: Emergency Medicine
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 / 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 EMERGENCY MEDICINE
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: INTEGRIS Baptist Medical Center
Oklahoma City, OK
Moore Medical Center
Moore, OK
Norman Regional Healthplex
Norman, OK
Norman Regional Hospital
Norman, OK
Locations: Hours: Languages:
3300 NW EXPRESSWAY
OKLAHOMA CITY OK 73112

Phone #: (405) 949-4029
Fax #:
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
TAYLOR BROOKE HERZER PA 2937
KALLIE BLYTHE HUMPHREYS PA 2188
CHRISTY ANN MILLER PA 1895
REBECCA RUTH WELLINGTON PA 2125

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