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Oklahoma Board of Medical Licensure and Supervision

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

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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: REGIONAL BRAIN INSTITUTE
10109 E 79TH ST
TULSA OK 74133

Address last updated on 2/26/2024
Phone #: (918) 607-7842
Fax #:
County: TULSA
License: 4533
Dated: 2/9/2021
Expires: 3/31/2025
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:
REGIONAL BRAIN INSTITUTE
10109 E 79TH ST
TULSA OK 74133

Phone #: (918) 607-7842
Fax #:

Hospital Privileges:

Creek Nation Community Hospital
Okemah, OK
Hillcrest Medical Center
Tulsa, OK
Muscogee (Creek) Nation Medical Center (Okmulgee Mem. Hosp.)
Okmulgee, OK

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
VERONICA AVILA MD 27310
PAVAN BRAR MD 27791
Catherine Gail Cudnoski DO 4894
Aaron Ross Isley DO 5572
Cyriece Jones DO 6988
STEPHEN MIKUS DO 5045
NIGEL N NAMAN MD 32500
SURAJ SUKU MD 24622

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