TIEDE, JASON ALAN - Licensee Information

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Last Update: Saturday, December 21, 2024 3:49 AM CST
Next Update: Saturday, December 21, 2024 12:00 PM CST

TIEDE, JASON ALAN

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:	CITY OF OKLAHOMA CITY OCCUPATIONAL HEALTH CLINIC 1110 NORTH CLASSEN SUITE #205 OKLAHOMA CITY OK 73106 Address last updated on 3/25/2024
Phone #:	(405) 272-6677
Fax #:
County:	OKLAHOMA
License:	1482
Dated:	4/1/2006
Expires:	3/31/2025
Temp. Ltr. Issued:	12/15/2005
Temp. Ltr. Expires:	5/13/2006
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:
CITY OF OKLAHOMA CITY OCCUPATIONAL HEALTH CLINIC 1110 NORTH CLASSEN SUITE #205 OKLAHOMA CITY OK 73106 Phone #: (405) 272-6677 Fax #:

Hospital Privileges:

None listed

Name:	Type:	License Number:
Primary Supervisor(s):
RICHARD RANDALL MORGAN	MD	16168
KERSEY LEE WINFREE	MD	15752

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