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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Monday, April 29, 2024 9:10 AM CDT
Next Update: Monday, April 29, 2024 12:00 PM CDT

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BULLOCK, PETER PAUL JR
Practice Address: 301 S. MUSTANG ROAD
YUKON OK 73099-6704

Address last updated on 8/23/2023
Phone #: (405) 740-1159
Fax #:
County: CANADIAN
License: 25803
Dated: 9/1/2008
Expires: 9/1/2024
License Type: Medical Doctor
Specialty: Family Medicine
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of Ok Coll Of Med, Oklahoma City Ok 73190
Graduated: 5 / 2007
CME Year: 2026
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.
Certifications: AMERICAN BOARD OF FAMILY MEDICINE
New Patients: Yes
Medicaid: Yes
Medicare: Yes
   
HMO/PPO: Aetna HMO
Blue Cross Blue Shield-Blue Preferred
Blue Cross Blue Shield-Blue Traditional
Blue Cross Blue Shield-Plan 65 Select
BlueChoice PPO
BlueLincs HMO
CCN Managed Care
Champ VA
CIGNA HMO
CIGNA PPO
CommunityCare HMO, Inc
CommunityCare Senior HMO
Coventry Health Care National Network
Global Health HMO
Great West Healthcare
Health Smart Preferred Care (HSPC)
HealthChoice
Heartland Health Plan of Oklahoma
Humana ChoiceCare
Humana Medicare Advantage PPO
Humana Tricare/PGBA
Medicare Blue
Multiplan PPO
Oklahoma Health Network PPO
Pacificare Commercial HMO
PacifiCare of Oklahoma, Inc
PHCS (Private Healthcare Systems)
PPO Oklahoma
PPO USA
Preferred Community Choice
Private Healthcare Systems (PHCS)
Railroad Medicare
Secure Horizons HMO
SoonerCare HMO
SoonerCare PPO
Tricare for Life
Tricare Standard
United Healthcare Choice
United Healthcare EPO
United Healthcare Options PPO
United Healthcare POS
United Insurance
USA Managed Care
Hospital Privileges: None listed
Locations: Hours: Languages:
301 S. MUSTANG ROAD
YUKON OK 73099-6704

Phone #: (405) 740-1159
Fax #:
Mon: 8:00AM - 8:00PM
Tue: 8:00AM - 8:00PM
Wed: 8:00AM - 8:00PM
Thu: 8:00AM - 8:00PM
Fri: 8:00AM - 8:00PM
Sat: 8:00AM - 8:00PM
Sun: 8:00AM - 8:00PM
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
SANDRA COOPER APRN 83522
LACEY KRISTINE JACOBS PA 2099
KYLE ERICK JOHNSON PA 1250
KELLY NESDAHL APRN 112029
KARLEE JO PFAFF PA 3130
ASHTON TYLER ROBERTSON PA 2918

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