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Oklahoma Board of Medical Licensure and Supervision

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

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STAUFFER, JENNIFER LYNN       
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: OSU PHYSICIANS
HOUSTON CENTER
717 S HOUSTON AVE
TULSA OK 74127

Address last updated on 5/22/2024
Phone #: (918) 586-4500
Fax #:
County: TULSA
License: 1882
Dated: 1/19/2010
Expires: 3/31/2025
Temp. Ltr. Issued: 12/29/2009
Temp. Ltr. Expires: 5/21/2010
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:
OSU PHYSICIANS
HOUSTON CENTER
717 S HOUSTON AVE
TULSA OK 74127

Phone #: (918) 586-4500
Fax #:

Hospital Privileges:

Ascension St. John Medical Center
Tulsa, OK
Hillcrest Medical Center
Tulsa, OK

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
Micah Jon Derby DO 5550
MOUSUMI SOM DO 4558

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