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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Friday, November 22, 2024 8:19 AM CST
Next Update: Friday, November 22, 2024 12:00 PM CST

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VAN ZANDT, BRYAN LEE       
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: MERCY HOSPITAL
4300 W. MEMORIAL ROAD
OKLAHOMA CITY OK 73120-8304

Address last updated on 3/4/2024
Phone #: (405) 752-3324
Fax #: (405) 752-3454
County: OKLAHOMA
License: 30458
Dated: 4/1/2014
Expires: 4/1/2025
License Type: Medical Doctor
Specialty: Vascular and Interventional Radiology
Diagnostic Radiology
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 / 2007
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 RADIOLOGY (Diagnostic Radiology specific)
AMERICAN BOARD OF RADIOLOGY (Diagnostic Radiology specific) - Vascular & Interventional Radiology
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: Aetna Elect Choice
Aetna HMO
Aetna Managed Choice
Aetna PPO
Beechstreet PPO
Blue Cross Blue Shield-Blue Preferred
Blue Cross Blue Shield-Blue Traditional
Blue Cross Blue Shield-Plan 65 Select
Blue Works Workers Comp
BlueChoice PPO
BlueLincs HMO
Champ VA
CIGNA HMO
CIGNA PPO
CommunityCare HMO, Inc
CommunityCare Senior HMO
CompMed
Coventry Health Care National Network
Dept of Rehabilitation Services (DRS)
First Health
Global Health HMO
Great West Healthcare
Health Payors Organization (HPO)
Health Smart Preferred Care (HSPC)
HealthChoice
Humana ChoiceCare
Humana Medicare Advantage PPO
Humana Tricare/PGBA
Medicare Blue
Multiplan PPO
National Preferred Provider Network (NPPN)
Oklahoma Health Network PPO
One Health Plan PPO
OSMA Health (formerly Plico PPO)
Pacificare Commercial HMO
PacifiCare of Oklahoma, Inc
PHCS (Private Healthcare Systems)
PPO Oklahoma
PPO USA
Preferred Community Choice
Preferred Health Network-ppoNEXT
Private Healthcare Systems (PHCS)
Prudential Health Care Plan, Inc
Railroad Medicare
Secure Horizons HMO
SoonerCare HMO
SoonerCare PPO
Tricare for Life
Tricare Standard
United Healthcare Choice
United Healthcare EPO
United Healthcare HMO
United Healthcare Options PPO
United Healthcare POS
United Insurance
Worknet of Oklahoma
Hospital Privileges: Mercy Hospital OKC
Oklahoma City, OK
Locations: Hours: Languages:
MERCY HOSPITAL
4300 W. MEMORIAL ROAD
OKLAHOMA CITY OK 73120-8304

Phone #: (405) 752-3324
Fax #: (405) 752-3454
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
NICOLE MARIE MASSIE PA 2727
STEVEN RUSSELL O'DELL PA 1321

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