BRAZEAL, TIFFANY GAIL - Licensee Information

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Last Update: Monday, April 29, 2024 4:03 AM CDT
Next Update: Monday, April 29, 2024 12:00 PM CDT

BRAZEAL, TIFFANY GAIL

Practice Address:	SSM DERMATOLOGY 9720 N BROADWAY EXTENSION OKLAHOMA CITY OK 73114 Address last updated on 3/28/2024
Phone #:	(405) 280-7546
Fax #:	(405) 772-8674
County:	OKLAHOMA
License:	27705
Dated:	5/17/2010
Expires:	5/1/2025
License Type:	Medical Doctor
Specialty:	Dermatology

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 / 2006
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.

Certifications:	AMERICAN BOARD OF DERMATOLOGY
New Patients:	Yes
Medicaid:	No
Medicare:	Yes

HMO/PPO:	None listed
Hospital Privileges:	St. Anthony Hospital (SSM Health) Oklahoma City, OK

Locations:	Hours:	Languages:
SSM DERMATOLOGY 9720 N BROADWAY EXTENSION OKLAHOMA CITY OK 73114 Phone #: (405) 280-7546 Fax #: (405) 772-8674	Mon: 8:00AM - 4:30PM Tue: Wed: Thu: Fri: Sat: Sun:
9720 N Broadway Extension Oklahoma City, OK 73114 Phone #: (405) 280-7546 Fax #: (2) 201-	Mon: 8:00AM - 5:00PM Tue: 8:00AM - 5:00PM Wed: 8:00AM - 5:00PM Thu: 8:00AM - 5:00PM Fri: Sat: Sun:
1440 N Mustang Road Mustang, OK 73064 Phone #: (405) 280-7546 Fax #: (5) 201-	Mon: Tue: Wed: 8:00AM - 4:00PM once per month Thu: Fri: Sat: Sun:

Name:	Type:	License Number:
Primary Supervisees(s):
AMY KATHLEEN HUGHES	PA	705
MADELINE ELAINE LUTTRELL	PA	2185
HEATHER A MCFADDEN	PA	2221
CHRISTY ANN NIEHUES	PA	826
KATIE MARIE WHITE	PA	2217