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Oklahoma Board of Medical Licensure and Supervision

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

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WILLIAMS, MADISON       
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: CLINIC (OSSO)
9800 BROADWAY EXT SUITE 203
OKLAHOMA CITY OK 73114

Address last updated on 3/14/2024
Phone #: (405) 330-8847
Fax #: (405) 330-8849
County: OKLAHOMA
License: 2718
Dated: 1/26/2017
Expires: 3/31/2025
Temp. Ltr. Issued: 1/24/2017
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:
CLINIC (OSSO)
9800 BROADWAY EXT SUITE 203
OKLAHOMA CITY OK 73114

Phone #: (405) 330-8847
Fax #: (405) 330-8849

Hospital Privileges:

Community Hospital - OKC
Oklahoma City, OK
INTEGRIS Edmond
Edmond, OK
Northwest Surgical Hospital
Oklahoma City, OK
Surgery Center of Oklahoma
Oklahoma City, OK

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
PAUL JACOB DO 5494
MICHAEL BRANDON JOHNSON MD 26521
RYAN NELSON DO 4672
RAYMOND GARRETT STEINMETZ MD 31497

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