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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Monday, December 23, 2024 1:13 PM CST
Next Update: Monday, December 23, 2024 4:30 PM CST

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JOHNSON, JEREMY JON       
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: 1200 EVERETT DR.
SUITE 2320
OKLAHOMA CITY OK 73104

Address last updated on 6/3/2024
Phone #: (405) 271-5922
Fax #:
County: OKLAHOMA
License: 26424
Dated: 7/1/2009
Expires: 7/1/2025
License Type: Medical Doctor
Specialty: General Surgery
Pediatric Surgery (Surgery)
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 / 2008
CME Year: 2027
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 SURGERY
AMERICAN BOARD OF SURGERY (Surgery specific) - Pediatric Surgery
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
1200 EVERETT DR.
SUITE 2320
OKLAHOMA CITY OK 73104

Phone #: (405) 271-5922
Fax #:
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
SHANNON MICHELLE JACOBY PA 1998
JULIE MARIE REDINGTON PA 1399
PATRICIANN MICHAEL TATE PA 1744
ANGELA MARIE WROBLESKI PA 1400

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