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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Monday, December 23, 2024 3:49 AM CST
Next Update: Monday, December 23, 2024 12:00 PM CST

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ROBERTS, GRANT DAVID       
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: SSM HEALTH BONE & JOINT
12401 N WESTERN
STE 301
OKLAHOMA CITY OK 73159

Address last updated on 3/5/2024
Phone #: (405) 218-2530
Fax #:
County: OKLAHOMA
License: 1204
Dated: 6/12/2002
Expires: 3/31/2025
Temp. Ltr. Issued: 4/4/2002
Temp. Ltr. Expires: 6/28/2002
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:
SSM HEALTH BONE & JOINT
12401 N WESTERN
STE 301
OKLAHOMA CITY OK 73159

Phone #: (405) 218-2530
Fax #:

Hospital Privileges:

Community Hospital - OKC
Oklahoma City, OK
Northwest Surgical Hospital
Oklahoma City, OK
St. Anthony North Ambulatory Surgery Center
Oklahoma City, OK

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
COREY EUGENE PONDER MD 22884

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