MOORE, MATTHEW HENRY - Licensee Information

Search Results

Last Update: Thursday, December 19, 2024 3:44 AM CST
Next Update: Thursday, December 19, 2024 12:00 PM CST

MOORE, MATTHEW HENRY

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:	NORTHEASTERN TRIBAL HEALTH SYSTEM 7600 S HIGHWAY CLINIC MIAMI OK 74354 Address last updated on 8/13/2024
Phone #:	(918) 542-1655
Fax #:
County:	OTTAWA
License:	1732
Dated:	4/23/2008
Expires:	3/31/2025
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:
NORTHEASTERN TRIBAL HEALTH SYSTEM 7600 S HIGHWAY CLINIC MIAMI OK 74354 Phone #: (918) 542-1655 Fax #:

Hospital Privileges:

None listed

Name:	Type:	License Number:
Primary Supervisor(s):
James C. Eaton	DO	2163
PAUL KONRAD FUHRMEISTER	MD	23275

Return to Search Licensees page