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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Friday, November 22, 2024 3:47 AM CST
Next Update: Friday, November 22, 2024 12:00 PM CST

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SMITH, JACK BRADLEY       
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: COMMUNITY HOSPITAL
3100 SW 89TH ST
OKLAHOMA CITY OK 73159

Address last updated on 10/14/2024
Phone #: (405) 486-6555
Fax #:
County: OKLAHOMA
License: 1155
Dated: 4/1/2002
Expires: 3/31/2025
Temp. Ltr. Issued: 1/10/2002
Temp. Ltr. Expires: 3/31/2002
License Type: Physician Assistant
Specialty:
Status: Active
Status Class: Fully Licensed
Restricted to:
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.
Locations: Hours: Languages:
COMMUNITY HOSPITAL
3100 SW 89TH ST
OKLAHOMA CITY OK 73159

Phone #: (405) 486-6555
Fax #:

Hospital Privileges:

Community Hospital - OKC
Oklahoma City, OK
SSM Health St. Anthony Hospital - OKC
Oklahoma City, OK
St. Anthony Healthplex - East Campus (I-40 & Douglas)
Oklahoma City, OK
St. Anthony Healthplex - South Campus (I-44 & SW 134th St)
Oklahoma City, OK

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
ANDREA SEGUE ANDREWS MD 26247
EDWARD RAYMOND ARMSTRONG MD 17271
CAROL AZADI DO 4879
JACK MARTIN BAIR MD 14272
CURTIS ERROL BALL DO 3932
CHAD BORIN DO 3746
JOSEPH CLIFTON BROOME MD 23006
RONALD M CABLE JR DO 3449
CONRAD C CALDWELL III MD 22805
DOUGLAS B COFFMAN DO 3251
VICTORIA C. CORBIN DO 4602
COLBY L. EDWARDS DO 4400
KEITH KURT FISCHBORN MD 27723
AFSANEH FOROOZAN DO 3094
SERGIO GREG GARCIA MD 28909
JEFFREY MICHAEL GOODLOE MD 25761
TERRY CHARLES HERMANCE MD 25607
JESSICA DAWN HILDEBRAND MD 24769
THOMAS EUGENE INGMIRE MD 17718
DATHAN DUANE JAY MD 23512
VALERIE NICOLE JOLLY MD 24633
ERIN POWERS KINNEY DO 5400
JAMES LE DO 5402
SANG LEE DO 3864
JASON MATTHEW LEINEN MD 25158
JULIE LEWIS DO 5247
DAVID ALLAN LONG II MD 20241
LARRY LOVELACE DO 2438
RYAN LYNCH DO 5406
JOSH ERIC MCWILLIAMS MD 23717
MARK GRADY MILES MD 18554
BRETT MATTHEW PROPES MD 22435
ERIC AVERY REDDICK MD 27847
SCOTT EDWIN ROGERS MD 27262
STANLEY CHRISTOPHER SHADID MD 29130
PHILIP LEON SLOAN MD 28808
STEPHEN KOJI SPARKS DO 4559
TARA D. STEWART DO 5252
KAREN KAY SWISHER MD 24053
JOHN WELLS DO 3607
WAYNE WILLIAMS DO 5131

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