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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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TIPPLE, TRENT EDWARD
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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.
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| Practice Address: |
1200 NORTH EVERETT DRIVE
OKLAHOMA CITY OK 73104
Address last updated on 8/3/2024 |
| Phone #: |
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| Fax #: |
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| County: |
OKLAHOMA |
| License: |
35182 |
| Dated: |
9/25/2019 |
| Expires: |
9/1/2025 |
| License Type: |
Medical Doctor |
| Specialty: |
Neonatal-Perinatal Medicine
Pediatrics |
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| Status: |
Active |
| Status Class: |
Fully Licensed |
| Restricted to: |
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| Registered to Dispense: |
NO |
| Medical School: |
IN Univ Sch Of Med, Indianapolis In 46202 |
| Graduated: |
5 /
2000 |
| CME Year: |
2025 |
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Pending and/or Past Disciplinary Actions:
No Disciplinary Action Taken.
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All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
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| Certifications: |
AMERICAN BOARD OF PEDIATRICS
AMERICAN BOARD OF PEDIATRICS - Neonatal-Perinatal Medicine |
| New Patients: |
Contact licensee |
| Medicaid: |
Contact licensee |
| Medicare: |
Contact licensee |
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| HMO/PPO: |
None listed |
| Hospital Privileges: |
OU Health Medical Center
Oklahoma City, OK
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Primary Supervisees(s):
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| Name: |
Type: |
License Number: |
Full/Part Time: |
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STACEY CULLINS
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APRN |
18198 |
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