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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Thursday, April 18, 2024 6:52 PM CDT
Next Update: Friday, April 19, 2024 2:50 AM CDT

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GREEN, ROBERT WAYNE
Practice Address: 1416 GLENMERE CT
EDMOND OK 73003

Address last updated on 3/24/2024
Phone #: (405) 209-8918
Fax #:
County: OKLAHOMA
License: 1526
Dated: 4/26/2006
Expires: 3/31/2025
Temp. Ltr. Issued: 1/20/2006
Temp. Ltr. Expires: 5/13/2006
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:
1416 GLENMERE CT
EDMOND OK 73003

Phone #: (405) 209-8918
Fax #:

Hospital Privileges:

Community Hospital - OKC
Oklahoma City, OK
INTEGRIS Deaconess Campus (fmly Deaconess Hospital)
Oklahoma City, OK
Northwest Surgical Hospital
Oklahoma City, OK
OU Medical Center - Edmond (frmrly Edmond Medical Center)
Edmond, OK
St. Anthony Hospital (SSM Health)
Oklahoma City, OK
Summit Medical Center
Edmond, OK

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
ELLEN ELAINE SQUIRE MD 32591
MATTHEW R STANFIELD MD 22616

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