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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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ASHLEY, CAITLIN MUMFORD       
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: PORTER HEALTHCARE
505 S MAIN ST
PORTER OK 74454

Address last updated on 3/1/2024
Phone #: (918) 483-0111
Fax #: (918) 483-0112
County: WAGONER
License: 2505
Dated: 4/30/2015
Expires: 3/31/2025
Temp. Ltr. Issued: 3/2/2015
Temp. Ltr. Expires: 5/15/2015
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:
PORTER HEALTHCARE
505 S MAIN ST
PORTER OK 74454

Phone #: (918) 483-0111
Fax #: (918) 483-0112

Hospital Privileges:

None listed

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
ASHLEY NOEL EVANS MD 24029

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