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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Sunday, December 22, 2024 6:44 PM CST
Next Update: Monday, December 23, 2024 2:50 AM CST

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HILDEBRAND, JESSICA DAWN       
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: OKLAHOMA CITY VA HOSPITAL
DEPARTMENT OF EMERGENCY MEDICINE
921 NE 13TH ST
OKLAHOMA CITY OK 73104

Address last updated on 1/22/2024
Phone #: (405) 456-3057
Fax #:
County: OKLAHOMA
License: 24769
Dated: 3/17/2006
Expires: 3/1/2025
License Type: Medical Doctor
Specialty: Emergency 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: 7 / 2004
CME Year: 2027
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
SSM Health St. Anthony Hospital - OKC
Oklahoma City, OK
V.A. Medical Center-OKC
Oklahoma City, OK
Locations: Hours: Languages:
OKLAHOMA CITY VA HOSPITAL
DEPARTMENT OF EMERGENCY MEDICINE
921 NE 13TH ST
OKLAHOMA CITY OK 73104

Phone #: (405) 456-3057
Fax #:
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
MATTHEW STEVEN BERTUS PA 861
BRENT MICHAEL DAVIS PA 2052
KALLIE BLYTHE HUMPHREYS PA 2188
SASA KOREN JACKSON PA 2107
FARZANA JAHANGIR PA 2494
CHRISTOPHER TODD JAMES PA 1231
JACK BRADLEY SMITH PA 1155
KATHRYN WALENZ PA 2588

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