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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Sunday, December 22, 2024 6:44 PM CST
Next Update: Monday, December 23, 2024 2:50 AM CST

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JACKSON, CARL DOUGLAS       
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: GREEN COUNTRY EMERGENCY PHYSICIANS
1145 S UTICA AVE STE 365
TULSA OK 74104

Address last updated on 12/18/2024
Phone #: (918) 728-3354
Fax #:
County: TULSA
License: 2616
Dated: 1/14/2016
Expires: 3/31/2025
Temp. Ltr. Issued: 1/8/2016
Temp. Ltr. Expires: 3/11/2016
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:
GREEN COUNTRY EMERGENCY PHYSICIANS
1145 S UTICA AVE STE 365
TULSA OK 74104

Phone #: (918) 728-3354
Fax #:

Hospital Privileges:

None listed

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
Randall H. Adolph DO 6349
RUSSELL ANDERSON DO 4498
OSAMA SALAH ANTAR MD 34726
CAROL AZADI DO 4879
ELIZABETH BADER DO 4738
LEIGH BARROW DO 4613
RENAE LYNNE BERNARD MD 27706
AIMEE BLAGOVICH DO 5889
WILLIAM JARVIS BOWEN MD 17278
BARRETT THOMAS BRADT MD 29420
Matthew Brice DO 6618
Erin Broderick DO 6620
ERIC JASON BROWN MD 25820
JANNA BURKUS DO 4883
BOYD BURNS DO 4282
JOSHUA TOBIN CALVERT MD 25602
ERIC MICHAEL CANADAY DO 5535
MATTHEW CARMICHAEL DO 6118
JERRY CASTLEBERRY DO 4481
JULIE CURRY DO 4398
THOMAS KENTON DENMARK MD 31977
JEFFREY DAVID DIXON MD 17328
KIMBERLY FELTEN DO 4603
EMILY MCMICHAEL FITZ MD 34118
ROBERT BROCK GOODWIN DO 4905
GREGORY H GRAY DO 2865
TESS HANNER DO 5223
EDWIN M HINTON DO 6307
GEORGE MICHAEL HUNIHAN II MD 33612
DAMIEN MARCELL JACKSON MD 34931
STEVEN BLAINE KATSIS MD 18954
CRAIG ALLEN KENNEDY MD 14981
JAMES RAYMOND KENNEDYE MD 22846
ANDREW JOSEPH KIENSTRA MD 34133
KEVIN THOMAS KIERL MD 29830
LOREN ELIZABETH KIERL MD 28485
DEREK JAMES KNOTTS MD 29223
DANA HOWARD LARSON MD 16757
LINDSEY GRAY LAWRENCE MD 34041
ERIC JOSEPH LEE MD 33417
Brandon Lewis DO 6695
Stephen J. Lojewski Jr. DO 6439
AMANDA MICHELLE MADDEN DO 5334
ABIGAIL MARIANA MARTINEZ MD 33574
KURTIS ALEXANDER MAYZ MD 34092
MELANIE KAY MCCARROLL MD 31263
SAMUEL THURSTON MONTGOMERY MD 35134
Tooba H. Naeem DO 6811
DAPHNEE ANNABELLE NOEL MD 42505
Shaina Susann Parks DO 6468
JOHN LEE PERONA JR MD 25873
CURTIS PHILLIPS DO 3379
MELANIE KAY PHILLIPS MD 26484
MIRANDA LOGAN PHILLIPS DO 4945
Sara Pope DO 6731
CHRISTOPHER ROBERT POST MD 33381
ERIC AVERY REDDICK MD 27847
Logan Rencher DO 6540
NATHAN G REUSSER DO 4266
DOUGLAS WAYNE RICHMOND MD 25821
KENDALL ROCKLER MD 33419
CHARLES RODMAN IV DO 4328
JOHN MARC SHELLENBERGER MD 34961
TRENT W SMITH DO 4716
CHRISTOPHER DAVID STOKES MD 31385
GARRETT ALAN TAYLOR MD 28414
DARREN ALAN THOMAS MD 22449
MATTHEW RAYMOND THOMAS MD 29193
TIMOTHY TOOLE MD 31293
DEBRA LYNNE VAN ZANDT MD 28577
ALEC MICHAEL WATSON MD 31603
WINNIE TUNG WHITAKER MD 34101
SAMANTHA LEIGH WHITESIDE MD 27775
DAVID PETER WIEBE MD 33213
ROBERT WESLEY WILSON MD 11833
JORDAN KATHLEEN WOLFE MD 33604
CATHERINE ELAINE YEE MD 34226
HILARY BETH YOKLEY MD 33559

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