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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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MILLER, JEFFREY ALLEN       
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: 1109 SW 30TH COURT
SUITE A AND B
MOORE OK 73160

Address last updated on 8/6/2024
Phone #: (405) 703-0937
Fax #: (888) 290-8567
County: OKLAHOMA
License: 25175
Dated: 7/1/2007
Expires: 7/1/2025
License Type: Medical Doctor
Specialty: Anesthesiology
Pain Management (Anesthesiology)
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 ANESTHESIOLOGY
AMERICAN BOARD OF ANESTHESIOLOGY - Pain Medicine
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
1109 SW 30TH COURT
SUITE A AND B
MOORE OK 73160

Phone #: (405) 703-0937
Fax #: (888) 290-8567
Mon: 8:00AM - 5:00PM
Tue: 8:00AM - 5:00PM
Wed: 8:00AM - 5:00PM
Thu: 8:00AM - 5:00PM
Fri: 8:00AM - 5:00PM
Sat:
Sun:
15132 Traditions Blvd
Edmond, OK 73013

Phone #: (405) 703-0937 x3
Fax #: (3) 202-
Mon: 8:00AM - 5:00PM
Tue: 8:00AM - 5:00PM
Wed: 8:00AM - 5:00PM
Thu: 8:00AM - 5:00PM
Fri: 8:00AM - 12:00PM
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
DONNA CROSS APRN 4369
DUSTI JOHNSON APRN 109268
TARA NARVAIZ APRN 104712
TIFFANY OGDEN APRN 95895

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