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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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BROGE, TANGRA LEA       
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: CHICKASAW NATION MEDICAL CENTER
1921 STONECIPHER BLVD.
ADA OK 74820

Address last updated on 8/9/2024
Phone #: (580) 272-8499
Fax #:
County: PONTOTOC
License: 31854
Dated: 9/15/2015
Expires: 9/1/2025
License Type: Medical Doctor
Specialty: Pediatrics
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: NO
Medical School: American Univ Of The Caribbean, Sch Of Med, St Maarten, Netherlands Antille
Graduated: 4 / 2011
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 PEDIATRICS
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: Chickasaw Nation Medical Ctr (fmly Carl Albert Indian Health Facility-IHS)
Ada, OK
Mercy Memorial Health Center, Inc. - Ardmore
Ardmore, OK
Locations: Hours: Languages:
CHICKASAW NATION MEDICAL CENTER
1921 STONECIPHER BLVD.
ADA OK 74820

Phone #: (580) 272-8499
Fax #:
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
TAMMY HORTON APRN 132396
LESLEY KEESEE APRN 80872
ROBIN LOSEE APRN 110671

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