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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Friday, November 22, 2024 8:19 AM CST
Next Update: Friday, November 22, 2024 12:00 PM CST

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LEINEN, JASON MATTHEW       
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: 3110 SW 89TH ST
SUITE 102C
OKLAHOMA CITY OK 73159-7920

Address last updated on 8/22/2024
Phone #: (405) 703-3611
Fax #: (405) 703-3711
County: OKLAHOMA
License: 25158
Dated: 9/14/2007
Expires: 9/1/2025
License Type: Medical Doctor
Specialty: Family Medicine
Sports Medicine (Family Practice)
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 / 2006
CME Year: 2025
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 FAMILY MEDICINE
AMERICAN BOARD OF FAMILY MEDICINE - Sports Medicine
New Patients: Yes
Medicaid: Yes
Medicare: Yes
   
HMO/PPO: None listed
Hospital Privileges: Community Hospital - OKC
Oklahoma City, OK
Locations: Hours: Languages:
3110 SW 89TH ST
SUITE 102C
OKLAHOMA CITY OK 73159-7920

Phone #: (405) 703-3611
Fax #: (405) 703-3711
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
DUSTIN COREY BROOKS PA 2731
TOMMY DEAN CAMP PA 880
PHILLIP WILLIAM EASTERLY AT 713
LEE MAC GERMANY PA 1717
CHRISTOPHER TODD JAMES PA 1231
DEBORAH LEE APRN 101851
JEFFREY DONOVAN MARTENS PA 704
JACK BRADLEY SMITH PA 1155
JERAMIAH WALKER APRN 73208

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