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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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DRYWATER, STEPHN       
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: CHEROKEE NATION W. W. HASTINGS HOSPITAL
100 BLISS AVE TAHLEQUAH OK 74464
TAHLEQUAH OK 74464

Address last updated on 6/24/2024
Phone #: (918) 458-3100
Fax #:
County: CHEROKEE
License: 30727
Dated: 7/1/2015
Expires: 7/1/2025
License Type: Medical Doctor
Specialty: Emergency Medicine
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: YES
Medical School: Sanford Sch of Med of the Univ of SD, Vermillion, SD
Graduated: 5 / 2014
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 EMERGENCY MEDICINE
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
CHEROKEE NATION W. W. HASTINGS HOSPITAL
100 BLISS AVE TAHLEQUAH OK 74464
TAHLEQUAH OK 74464

Phone #: (918) 458-3100
Fax #:
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:
100 Bliss Ave
Tahlequah, OK 74464

Phone #: (918) 458-3100
Fax #: (7) 201-
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
MARY KAY DAUGHERTY PA 4776
LEE MAC GERMANY PA 1717
JESSICA MICHELE RANDOLPH PA 3205

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