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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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TEETER, JAMIE SCOTT       
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: ASCENSION MEDICAL GROUP ST JOHN GENERAL SURGERY BR
800 W BOISE CIRCLE SUITE 280
BROKEN ARROW OK 74012

Address last updated on 3/7/2024
Phone #: (918) 403-7060
Fax #: (918) 403-6402
County: TULSA
License: 2005
Dated: 1/21/2011
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:
ASCENSION MEDICAL GROUP ST JOHN GENERAL SURGERY BR
800 W BOISE CIRCLE SUITE 280
BROKEN ARROW OK 74012

Phone #: (918) 403-7060
Fax #: (918) 403-6402

Hospital Privileges:

Ascension St. John - Sapulpa
Sapulpa, OK
Ascension St. John Hospital - Broken Arrow
Broken Arrow, OK
Ascension St. John Medical Center
Tulsa, OK

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
STEFFAN GREGORY ANDERSON MD 24629
KIP WESTON DORSEY MD 25838
CHARLES ANTHONY HOWARD MD 14841
LUKE E MATLOFF DO 4730
KELLY KAZUAKI NAGASAWA MD 34715
MICHAEL RAY PHILLIPS MD 29306
STEVEN LEE PIKE MDC 43634

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