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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Monday, December 23, 2024 3:49 AM CST
Next Update: Monday, December 23, 2024 12:00 PM CST

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SMITH, LESLEY JEANINE       
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: 921 NE 13TH ST
OKLAHOMA CITY OK 73104

Address last updated on 3/24/2024
Phone #: (405) 456-1000
Fax #:
County: OKLAHOMA
License: 825
Dated: 4/1/1997
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:
921 NE 13TH ST
OKLAHOMA CITY OK 73104

Phone #: (405) 456-1000
Fax #:

Hospital Privileges:

Ascension St. John - Owasso
Owasso, OK
Ascension St. John - Sapulpa
Sapulpa, OK
Ascension St. John Hospital - Broken Arrow
Broken Arrow, OK
Hospital Not Listed
,

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
WALTER MARK BOOMER MD 17300
BRADLEY DUANE LOWERY MD 16960
DARREN ALAN THOMAS MD 22449

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