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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Wednesday, December 25, 2024 1:14 PM CST
Next Update: Wednesday, December 25, 2024 4:30 PM CST

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GOODMAN, IAN 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: 12455 E. 100TH ST. NO.
OWASSO OK 74055-4674

Address last updated on 12/4/2024
Phone #: (918) 392-1513
Fax #: (918) 392-1590
County: TULSA
License: 39030
Dated: 2/22/2022
Expires: 2/1/2026
License Type: Medical Doctor
Specialty: Orthopedic Surgery
Sports Medicine (Orthopedic Surgery)
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: YES
Medical School: Univ Of AR Coll Of Med, Little Rock AR 72205
Graduated: 5 / 2012
CME Year: 2028
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 - Owasso
Owasso, OK
Ascension St. John Medical Center
Tulsa, OK
Baily Medical Center
Owasso, OK
St. Francis Hospital
Tulsa, OK
St. Francis Hospital - SOUTH
Tulsa, OK
Locations: Hours: Languages:
12455 E. 100TH ST. NO.
OWASSO OK 74055-4674

Phone #: (918) 392-1513
Fax #: (918) 392-1590
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:
DAVID ANDREW CROWLEY PA 5126
KAYLEN ANNE LANIER PA 4930
JOHNATHON DAVID MILLWEE AT 803

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