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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Friday, November 22, 2024 6:42 PM CST
Next Update: Saturday, November 23, 2024 2:50 AM CST

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PORTER, JUSTIN       
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: 3601 NW 138TH STREET
OKLAHOMA CITY OK 73134

Address last updated on 2/19/2024
Phone #: (405) 242-4100
Fax #: (405) 775-9356
County: OKLAHOMA
License: 29694
Dated: 4/1/2013
Expires: 4/1/2025
License Type: Medical Doctor
Specialty: Anesthesiology
Pain Management (Anesthesiology)
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: 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 ANESTHESIOLOGY
AMERICAN BOARD OF ANESTHESIOLOGY - Pain Medicine
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: Community Hospital - OKC
Oklahoma City, OK
Mercy Hospital OKC
Oklahoma City, OK
Oklahoma Spine Hospital
Oklahoma City, OK
Surgical Hospital of Oklahoma
Oklahoma City, OK
Locations: Hours: Languages:
3601 NW 138TH STREET
OKLAHOMA CITY OK 73134

Phone #: (405) 242-4100
Fax #: (405) 775-9356
Mon: 8:00AM - 4:30PM
Tue: 8:00AM - 4:30PM
Wed: 8:00AM - 4:30PM
Thu: 8:00AM - 4:30PM
Fri: 8:00AM - 4:30PM
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
SHAILYNNE ESTELLE CLORAN PA 1961
REBECCA O'DONNELL APRN 96348
COURTNEY LEE PATIN PA 1894
KELLI SULLIVAN APRN 16574

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