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Next Update: Thursday, December 19, 2024 2:50 AM CST
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MATHIS, JENNIFER LYNN
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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.
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| Practice Address: |
1323 W KEETOOWAH ST
TAHLEQUAH OK 74464
Address last updated on 4/26/2023 |
| Phone #: |
(918) 456-0641 |
| Fax #: |
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| County: |
CHEROKEE |
| License: |
25428 |
| Dated: |
2/12/2007 |
| Expires: |
2/1/2025 |
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Temp.
Lic.
Issued:
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1/17/2007 |
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Temp.
Lic.
Expires:
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3/24/2007 |
| License Type: |
Medical Doctor |
| Specialty: |
Family Medicine
Addiction Medicine |
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| Status: |
Active |
| Status Class: |
Fully Licensed |
| Restricted to: |
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| Registered to Dispense: |
YES |
| Medical School: |
Univ Of Ok Coll Of Med, Oklahoma City Ok 73190 |
| Graduated: |
6 /
2003 |
| CME Year: |
2025 |
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Pending and/or Past Disciplinary Actions:
No Disciplinary Action Taken.
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All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
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| Certifications: |
AMERICAN BOARD OF FAMILY MEDICINE
AMERICAN BOARD OF PREVENTIVE MEDICINE - Addiction Medicine |
| New Patients: |
Contact licensee |
| Medicaid: |
Contact licensee |
| Medicare: |
Contact licensee |
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| HMO/PPO: |
None listed |
| Hospital Privileges: |
Northeastern Health System (formerly Tahlequah City Hospital)
Tahlequah, OK
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| Locations: |
Hours: |
Languages: |
1323 W KEETOOWAH ST
TAHLEQUAH OK 74464
Phone #:
(918) 456-0641
Fax #:
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Mon: 5:30AM - 3:00PM
Tue: 5:30AM - 3:00PM
Wed: 5:30AM - 3:00PM
Thu: 5:30AM - 3:00PM
Fri: 5:30AM - 3:00PM
Sat:
Sun: |
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Primary Supervisees(s):
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| Name: |
Type: |
License Number: |
Full/Part Time: |
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ALICIA SANDERS
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APRN |
6104 |
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