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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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ELLIS, BRIAN THOMAS       
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: 3261 24TH AVENUE NW SUITE 101
NORMAN OK 73069

Address last updated on 7/2/2024
Phone #: (405) 364-6432
Fax #: (405) 364-0090
County: CLEVELAND
License: 26325
Dated: 8/1/2008
Expires: 8/1/2025
License Type: Medical Doctor
Specialty: Pediatrics
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of Ok Coll Of Med, Oklahoma City Ok 73190
Graduated: 5 / 2006
CME Year: 2026
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 PEDIATRICS
New Patients: Yes
Medicaid: Yes
Medicare: No
   
HMO/PPO: None listed
Hospital Privileges: J.D. McCarty Center for Children
Norman, OK
Moore Medical Center
Moore, OK
Norman Regional Hospital
Norman, OK
Locations: Hours: Languages:
3261 24TH AVENUE NW SUITE 101
NORMAN OK 73069

Phone #: (405) 364-6432
Fax #: (405) 364-0090
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:
1700 S Broadway
Suite I
Moore, OK 73160

Phone #: (405) 364-6432
Fax #: (4) 201-
Mon: 9:00AM - 5:00PM
Tue: 9:00AM - 5:00PM
Wed: 9:00AM - 5:00PM
Thu: 9:00AM - 5:00PM
Fri: 9:00AM - 5:00PM
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
RHIANNON BAKER APRN 111611
KELLI BRYAN APRN 80749
AMANDA LOWRY APRN 79704
CAROLINE TROMMELS APRN 103736

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