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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Wednesday, December 18, 2024 6:43 PM CST
Next Update: Thursday, December 19, 2024 2:50 AM CST

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PETERSON, JENNIFER       
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: 4802 S. 109TH E. AVE
TULSA OK 74146

Address last updated on 3/18/2024
Phone #: (918) 392-1400
Fax #: (918) 392-1488
County: TULSA
License: 34618
Dated: 4/1/2019
Expires: 4/1/2025
License Type: Medical Doctor
Specialty: Orthopedic Surgery
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: NO
Medical School: UNIV OF VA SCH OF MED HLTH SYS, CHARLOTTESVILLE VA 22908
Graduated: 5 / 2013
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 ORTHOPAEDIC SURGERY
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: Ascension St. John Hospital - Broken Arrow
Broken Arrow, OK
Ascension St. John Medical Center
Tulsa, OK
Hillcrest Medical Center
Tulsa, OK
St. Francis Hospital
Tulsa, OK
St. Francis Hospital - SOUTH
Tulsa, OK
Locations: Hours: Languages:
4802 S. 109TH E. AVE
TULSA OK 74146

Phone #: (918) 392-1400
Fax #: (918) 392-1488
Mon: 8:00AM - 5:00PM
Tue: 8:00AM - 5:00PM
Wed: 8:00AM - 5:00PM
Thu: 8:00AM - 5:00PM
Fri: 8:00AM - 5:00PM
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
EMMALEIGH GRACE NORTHCUTT PA 5357

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