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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Wednesday, December 18, 2024 6:43 PM CST
Next Update: Thursday, December 19, 2024 2:50 AM CST

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ACKERMAN, AUTUMN RENAE       
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: OU FAMILY MEDICINE
1111 S. ST LOUIS AVE
TULSA OK 74120

Address last updated on 5/17/2024
Phone #: (918) 619-4600
Fax #:
County: TULSA
License: 1529
Dated: 4/26/2006
Expires: 3/31/2025
Temp. Ltr. Issued: 1/26/2006
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:
OU FAMILY MEDICINE
1111 S. ST LOUIS AVE
TULSA OK 74120

Phone #: (918) 619-4600
Fax #:

Hospital Privileges:

None listed

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
DOUGLAS JOHN IVINS MD 23164
JAMES STUART MILLAR MD 12344
LOUIS E MULKEY DO 3479
JOHN WYLIE TIPTON MD 10115
L JANELLE WHITT DO 3610

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