ROBERTSON, ANTHONY TYLER - Licensee Information

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Last Update: Wednesday, December 18, 2024 6:43 PM CST
Next Update: Thursday, December 19, 2024 2:50 AM CST

ROBERTSON, ANTHONY TYLER

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:	OKLAHOMA CITY VA MEDICAL CENTER OUTPATIENT CLINIC, HOSPITAL 921 NE 13TH STREET OKLAHOMA CITY OK 73104 Address last updated on 5/21/2024
Phone #:	(405) 456-1000
Fax #:
County:	OKLAHOMA
License:	2660
Dated:	4/28/2017
Expires:	3/31/2025
Temp. Ltr. Issued:	3/22/2017
Temp. Ltr. Expires:	5/4/2017
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:
OKLAHOMA CITY VA MEDICAL CENTER OUTPATIENT CLINIC, HOSPITAL 921 NE 13TH STREET OKLAHOMA CITY OK 73104 Phone #: (405) 456-1000 Fax #:

Hospital Privileges:

V.A. Medical Center-OKC
Oklahoma City, OK

Name:	Type:	License Number:
Primary Supervisor(s):
KATSIARYNA BAILOR	MD	27455
JOHN ROLAND HOUCK	MD	17455

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