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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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STAFFORD, GREGORY LEE       
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: WW HASTINGS HOSPITAL
100 BLIS AV
TAHLEQUAH OK 74464

Address last updated on 2/14/2024
Phone #: (660) 542-1698 x3200
Fax #:
County: CHEROKEE
License: 4960
Dated: 4/1/2023
Expires: 3/31/2025
Temp. Ltr. Issued: 11/18/2022
Temp. Ltr. Expires: 5/11/2023
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:
WW HASTINGS HOSPITAL
100 BLIS AV
TAHLEQUAH OK 74464

Phone #: (660) 542-1698 x3200
Fax #:

Hospital Privileges:

None listed

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
Thomas Fruits DO 6654
FARSHID ADAM-AMIR ZANDI MD 22558

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