HOMER, CAROL LE - Licensee Information

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Last Update: Friday, November 22, 2024 6:42 PM CST
Next Update: Saturday, November 23, 2024 2:50 AM CST

HOMER, CAROL LE

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:	INTEGRIS CANADIAN VALLEY HOSPITAL 1201 HEALTH CENTER PARKWAY YUKON OK 73099 Address last updated on 3/13/2024
Phone #:	(405) 717-6800
Fax #:
County:	CANADIAN
License:	2163
Dated:	10/22/2012
Expires:	3/31/2025
Temp. Ltr. Issued:	10/19/2012
Temp. Ltr. Expires:	11/8/2012
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:
INTEGRIS CANADIAN VALLEY HOSPITAL 1201 HEALTH CENTER PARKWAY YUKON OK 73099 Phone #: (405) 717-6800 Fax #:

Hospital Privileges:

None listed

Name:	Type:	License Number:
Primary Supervisor(s):
JAMES ROSS DAVIS	DO	3657
ERIN COLLETTE KELLY	MD	27649
Tyler Clayton Stephens	DO	5818

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