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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Wednesday, December 18, 2024 6:43 PM CST
Next Update: Thursday, December 19, 2024 2:50 AM CST

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BALLEW, JASON JASPER       
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: NORTHEASTERN HEALTH SYSTEM - TAHLEQUAH
1400 E DOWNING ST
TAHLEQUAH OK 74464

Address last updated on 4/9/2024
Phone #: (918) 456-0641
Fax #:
County: OKLAHOMA
License: 25130
Dated: 6/21/2006
Expires: 6/1/2025
License Type: Medical Doctor
Specialty: Emergency Medicine
Addiction 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: 5 / 2003
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
AMERICAN BOARD OF PREVENTIVE MEDICINE - Addiction Medicine
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: Northeastern Health System (formerly Tahlequah City Hospital)
Tahlequah, OK
Locations: Hours: Languages:
NORTHEASTERN HEALTH SYSTEM - TAHLEQUAH
1400 E DOWNING ST
TAHLEQUAH OK 74464

Phone #: (918) 456-0641
Fax #:
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
MICHAEL HOLT APRN 5318

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