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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Thursday, December 19, 2024 1:14 PM CST
Next Update: Thursday, December 19, 2024 4:30 PM CST

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MUNDY, RYAN 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: PREMIER PEDIATRIC AND ADOLESCENT CARE
2009 N MAIN
MUSKOGEE OK 74401-4131

Address last updated on 6/10/2024
Phone #: (918) 816-4024
Fax #: (918) 816-4025
County: MUSKOGEE
License: 27222
Dated: 7/1/2010
Expires: 7/1/2025
License Type: Medical Doctor
Specialty: Pediatrics
Adolescent Medicine (Pediatrics)
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 / 2009
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 PEDIATRICS
New Patients: Yes
Medicaid: Yes
Medicare: No
   
HMO/PPO: Aetna Elect Choice
Aetna HMO
Aetna Managed Choice
Aetna PPO
Blue Cross Blue Shield-Blue Preferred
Blue Cross Blue Shield-Blue Traditional
Blue Works Workers Comp
BlueChoice PPO
BlueLincs HMO
Champ VA
CIGNA HMO
CIGNA PPO
CommunityCare HMO, Inc
Coventry Health Care National Network
Global Health HMO
HealthChoice
Humana ChoiceCare
Tricare Standard
United Healthcare Choice
United Healthcare EPO
United Healthcare HMO
Hospital Privileges: St. Francis Hospital - Muskogee (frmly Muskogee Reg. Med. Ctr./Eastar)
Muskogee, OK
Locations: Hours: Languages:
PREMIER PEDIATRIC AND ADOLESCENT CARE
2009 N MAIN
MUSKOGEE OK 74401-4131

Phone #: (918) 816-4024
Fax #: (918) 816-4025
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:
Premier Pediatric and Adolescent Care of Bixby
7814 E 121st St
Bixby, OK 74008

Phone #: (918) 943-5777
Fax #: (5) 202-
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:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
AISHIA GLADNEY APRN 1704
REBEKAH LABOUFF APRN 102805
ASHTON LINDSEY APRN 98095

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