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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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FULLER, ALEN MUNSON       
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: 1725 E 19TH ST #100
TULSA OK 74104-+542

Address last updated on 4/3/2024
Phone #: (918) 742-7376
Fax #: (918) 743-2117
County: TULSA
License: 7801
Dated: 6/1/1961
Expires: 6/1/2025
License Type: Medical Doctor
Specialty: Otolaryngology
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: / 1961
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 OTOLARYNGOLOGY
New Patients: Yes
Medicaid: No
Medicare: Yes
   
HMO/PPO: Aetna Elect Choice
Aetna Managed Choice
Aetna PPO
Beechstreet PPO
Blue Cross Blue Shield-Blue Preferred
Blue Cross Blue Shield-Blue Traditional
Blue Cross Blue Shield-Plan 65 Select
BlueChoice PPO
CIGNA PPO
CompMed
Coventry Health Care National Network
First Health
HealthChoice
Humana ChoiceCare
Humana Medicare Advantage PPO
Humana Tricare/PGBA
Medicare Blue
OSMA Health (formerly Plico PPO)
PHCS (Private Healthcare Systems)
PPO USA
Preferred Community Choice
Preferred Health Network-ppoNEXT
Private Healthcare Systems (PHCS)
Railroad Medicare
Secure Horizons HMO
Tricare for Life
United Healthcare EPO
United Healthcare Options PPO
United Healthcare POS
Hospital Privileges: Ascension St. John Medical Center
Tulsa, OK
Hillcrest Hospital South (fmly SouthCrest)
Tulsa, OK
Locations: Hours: Languages:
1725 E 19TH ST #100
TULSA OK 74104-+542

Phone #: (918) 742-7376
Fax #: (918) 743-2117
Mon: 9:30AM - 3:00PM
Tue: 9:30AM - 3:00PM
Wed: 9:30AM - 3:00PM
Thu: 9:30AM - 3:00PM
Fri: 9:30AM - 12:00PM
Sat:
Sun:

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