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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Sunday, November 24, 2024 3:47 AM CST
Next Update: Sunday, November 24, 2024 12:00 PM CST

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WEST, LISA DANETTE       
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: CLASSEN FAMILY MEDICINE
1015 S.W. 4TH STREET ST
MOORE OK 73160

Address last updated on 3/19/2024
Phone #: (405) 378-2001
Fax #: (405) 445-7660
County: CLEVELAND
License: 1163
Dated: 4/1/2002
Expires: 3/31/2025
Temp. Ltr. Issued: 12/13/2001
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:
CLASSEN FAMILY MEDICINE
1015 S.W. 4TH STREET ST
MOORE OK 73160

Phone #: (405) 378-2001
Fax #: (405) 445-7660

Hospital Privileges:

None listed

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
KATHRYN HALL DO 2952
RANDALL L KEMP DO 2875
STEPHEN KOVACS DO 3860
BRENDA JOYCE MAH-MCCAA MD 34369
RODNEY MCCRORY DO 2750

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