PELTON, TODD BRADFORD - 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

PELTON, TODD BRADFORD

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:	ABSENTEE SHAWNEE TRIBAL HEALTH AUTHORITY, INC 15951 LITTLE AXE DRIVE NORMAN OK 73026 Address last updated on 4/18/2024
Phone #:	(405) 447-0300
Fax #:
County:	CLEVELAND
License:	968
Dated:	5/27/1999
Expires:	3/31/2025
Temp. Ltr. Issued:	3/3/1999
Temp. Ltr. Expires:	7/24/1999
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:
ABSENTEE SHAWNEE TRIBAL HEALTH AUTHORITY, INC 15951 LITTLE AXE DRIVE NORMAN OK 73026 Phone #: (405) 447-0300 Fax #:

Hospital Privileges:

None listed

Name:	Type:	License Number:
Primary Supervisor(s):
JOHNNY JOHNSON	DO	4712
KATHRYN JANE LOFGREN	MD	26003

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