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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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BOURLAND, JOE BYNUM       
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: 3400 W TECUMSEH ROAD STE 101
NORMAN OK 73072

Address last updated on 8/27/2024
Phone #: (405) 360-6764
Fax #: (405) 360-6769
County: OKLAHOMA
License: 899
Dated: 6/19/1998
Expires: 3/31/2025
Temp. Ltr. Issued: 5/15/1998
Temp. Ltr. Expires: 7/25/1998
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:
3400 W TECUMSEH ROAD STE 101
NORMAN OK 73072

Phone #: (405) 360-6764
Fax #: (405) 360-6769

Hospital Privileges:

None listed

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
THEODORE ALAN BOEHM MD 23491
JAMES JASON JACKSON MD 27258

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