COOPER, KELLY MICHELLE - Licensee Information

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

COOPER, KELLY MICHELLE

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:	OSH PHYSICAN GROUP 14100 PARKWAY COMMONS DR STE 102 OKLAHOMA CITY OK 73134 Address last updated on 11/26/2024
Phone #:	(405) 418-4033
Fax #:	(405) 930-4003
County:	OKLAHOMA
License:	874
Dated:	4/1/1998
Expires:	3/31/2025
Temp. Ltr. Issued:	8/7/1997
Temp. Ltr. Expires:	8/7/1998
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:
OSH PHYSICAN GROUP 14100 PARKWAY COMMONS DR STE 102 OKLAHOMA CITY OK 73134 Phone #: (405) 418-4033 Fax #: (405) 930-4003

Hospital Privileges:

Oklahoma Spine Hospital
Oklahoma City, OK

Name:	Type:	License Number:
Primary Supervisor(s):
JOSHUA MICHAEL HENRY	MD	34571
NATHAN OVERBEY	MD	29872
ANDREW BENJAMIN PARKINSON	MD	26131
GRETCHEN MILLER WIENECKE	MD	20186

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