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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Monday, December 23, 2024 3:49 AM CST
Next Update: Monday, December 23, 2024 12:00 PM CST

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BRAZEAL, TIFFANY GAIL       
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: SSM DERMATOLOGY
9720 N BROADWAY EXTENSION
OKLAHOMA CITY OK 73114

Address last updated on 3/28/2024
Phone #: (405) 280-7546
Fax #: (405) 772-8674
County: OKLAHOMA
License: 27705
Dated: 5/17/2010
Expires: 5/1/2025
License Type: Medical Doctor
Specialty: Dermatology
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: 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 DERMATOLOGY
New Patients: Yes
Medicaid: No
Medicare: Yes
   
HMO/PPO: None listed
Hospital Privileges: SSM Health St. Anthony Hospital - OKC
Oklahoma City, OK
Locations: Hours: Languages:
SSM DERMATOLOGY
9720 N BROADWAY EXTENSION
OKLAHOMA CITY OK 73114

Phone #: (405) 280-7546
Fax #: (405) 772-8674
Mon: 8:00AM - 4:30PM
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:
9720 N Broadway Extension
Oklahoma City, OK 73114

Phone #: (405) 280-7546
Fax #: (2) 201-
Mon: 8:00AM - 5:00PM
Tue: 8:00AM - 5:00PM
Wed: 8:00AM - 5:00PM
Thu: 8:00AM - 5:00PM
Fri:
Sat:
Sun:
1440 N Mustang Road
Mustang, OK 73064

Phone #: (405) 280-7546
Fax #: (5) 201-
Mon:
Tue:
Wed: 8:00AM - 4:00PM once per month
Thu:
Fri:
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
AMY KATHLEEN HUGHES PA 705
MADELINE ELAINE LUTTRELL PA 2185
HEATHER A MCFADDEN PA 2221
CHRISTY ANN NIEHUES PA 826
KATIE MARIE WHITE PA 2217

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