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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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HOUSE, SAVANNAH VICTORIA       
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: JACK C MONTGOMERY VAMC
1011 HONOR HEIGHTS DR
MUSKOGEE OK 74401

Address last updated on 2/16/2024
Phone #: (918) 577-3658
Fax #:
County: MUSKOGEE
License: 4732
Dated: 2/9/2022
Expires: 3/31/2025
Temp. Ltr. Issued: 1/25/2022
Temp. Ltr. Expires: 3/10/2022
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:
JACK C MONTGOMERY VAMC
1011 HONOR HEIGHTS DR
MUSKOGEE OK 74401

Phone #: (918) 577-3658
Fax #:

Hospital Privileges:

None listed

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
STEPHEN DON BRUNS MD 20793

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