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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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MOORE, JEREMY ADAM       
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: 3650 WEST ROCK CREEK ROAD
SUITE 110 A
NORMAN OK 73072

Address last updated on 4/3/2024
Phone #: (405) 364-2666
Fax #: (405) 364-9627
County: CLEVELAND
License: 25527
Dated: 5/1/2007
Expires: 5/1/2025
License Type: Medical Doctor
Specialty: Otolaryngology
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: 6 / 2002
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: ABPS - Surgery
AMERICAN BOARD OF OTOLARYNGOLOGY
National Board of Physicians and Surgeons - Otolaryngology
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: Community Hospital - OKC
Oklahoma City, OK
Moore Medical Center
Moore, OK
Norman Regional Hospital
Norman, OK
Locations: Hours: Languages:
3650 WEST ROCK CREEK ROAD
SUITE 110 A
NORMAN OK 73072

Phone #: (405) 364-2666
Fax #: (405) 364-9627
Mon: 8:00AM - 5:00PM
Tue: 8:00AM - 5:00PM
Wed: 8:00AM - 5:00PM
Thu: 8:00AM - 5:00PM
Fri: 8:00AM - 3:00PM
Sat:
Sun:
2002 12th ave NW
Ardmore, OK 73410

Phone #: (580) 226-8646
Fax #: (1) 202-
Mon: 8:15AM - 5:00PM
Tue: 8:15AM - 5:00PM
Wed: 8:15AM - 5:00PM
Thu: 8:15AM - 5:00PM
Fri: 8:15AM - 3:00PM
Sat:
Sun:
Spanish
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
NICOLE RACHELLE ELKINS PA 1788
JEFFREY ALAN FREDERICK PA 936

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