ELERICK, KELLY JAMES - 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

ELERICK, KELLY JAMES

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:	EASTERN OKLAHOMA VA HEALTHCARE SYSTEM 1011 HONOR HEIGHTS DRIVE MUSKOGEE OK 74401 Address last updated on 3/22/2024
Phone #:	(918) 577-3000
Fax #:
County:	MUSKOGEE
License:	915
Dated:	8/27/1998
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:
EASTERN OKLAHOMA VA HEALTHCARE SYSTEM 1011 HONOR HEIGHTS DRIVE MUSKOGEE OK 74401 Phone #: (918) 577-3000 Fax #:

Hospital Privileges:

None listed

Name:	Type:	License Number:
Primary Supervisor(s):
ROBERT E. FOX JR	DO	1578
ROCKY MAX MORGAN	MD	17305
MARK ALFORD RANDEL	MD	16951

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