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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Thursday, December 19, 2024 3:44 AM CST
Next Update: Thursday, December 19, 2024 12:00 PM CST

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GREEN, TIMOTHY PATRICK       
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: WILL ROGERS HEALTH CENTER
1020 LENAPE DR
NOWATA OK 74048

Address last updated on 5/2/2024
Phone #: (918) 273-7500
Fax #:
County: NOWATA
License: 31695
Dated: 7/1/2016
Expires: 7/1/2025
License Type: Medical Doctor
Specialty: Family Medicine
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: YES
Medical School: Univ Of Al Sch Of Med, Birmingham Al 35294
Graduated: 6 / 2015
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 FAMILY MEDICINE
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
WILL ROGERS HEALTH CENTER
1020 LENAPE DR
NOWATA OK 74048

Phone #: (918) 273-7500
Fax #:
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
TASHA LUNSFORD APRN 64696
EMILY MARIE PETERSEN PA 4779
CRYSTAL WHITE APRN 91105

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