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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Saturday, December 21, 2024 6:44 PM CST
Next Update: Sunday, December 22, 2024 2:50 AM CST

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ROOSTAEYAN, OMID       
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: MERCY CLINIC PRIMARY CARE - NORTH PORTLAND
18503 PORTLAND AVE
EDMOND OK 73012-9149

Address last updated on 4/2/2024
Phone #: (405) 531-4271
Fax #:
County: OKLAHOMA
License: 37981
Dated: 4/6/2021
Expires: 4/1/2025
License Type: Medical Doctor
Specialty: Family Medicine
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of Ok Coll Of Med, Oklahoma City Ok 73190
Graduated: 5 / 2018
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 FAMILY MEDICINE
New Patients: Yes
Medicaid: Yes
Medicare: Yes
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
MERCY CLINIC PRIMARY CARE - NORTH PORTLAND
18503 PORTLAND AVE
EDMOND OK 73012-9149

Phone #: (405) 531-4271
Fax #:
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:

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