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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Wednesday, April 17, 2024 6:57 PM CDT
Next Update: Thursday, April 18, 2024 2:50 AM CDT

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GREEN, PHIL JAMES
Practice Address: 223 EAST BLACKWELL
BLACKWELL OK 74631

Address last updated on 2/11/2024
Phone #: (580) 363-0943
Fax #: (580) 363-0930
County: KAY
License: 800
Dated: 12/26/1996
Expires: 3/31/2025
Temp. Ltr. Issued: 8/1/1996
Temp. Ltr. Expires: 8/1/1997
License Type: Physician Assistant
Specialty:
Status: Active
Status Class: Fully Licensed
Restricted to:
CME Year: 2025
Pending and/or Past Disciplinary Actions:
Date Action Reasons Remarks
9/15/2022 Voluntary Submittal to Jurisdiction
1/12/2022 Complaint Citation
Board Filings and/or Orders:
09/15/2022
01/12/2022
01/12/2022
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Locations: Hours: Languages:
223 EAST BLACKWELL
BLACKWELL OK 74631

Phone #: (580) 363-0943
Fax #: (580) 363-0930

Hospital Privileges:

None listed

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
MELINDA ALLEN DO 3741
Tammy K. Jarvis DO 3915

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