EASTERLY, PHILLIP WILLIAM - Licensee Information

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Last Update: Sunday, May 19, 2024 1:49 PM CDT
Next Update: Sunday, May 19, 2024 4:30 PM CDT

EASTERLY, PHILLIP WILLIAM

Practice Address:	138TH AIR FORCE NATIONAL GUARD 9100 E 46TH ST N TULSA OK 74115 Address last updated on 1/18/2024
Phone #:	(580) 541-6093
Fax #:
County:	TULSA
License:	713
Dated:	9/13/2012
Expires:	8/31/2024
License Type:	Athletic Trainer
Specialty:

Status:	Active
Status Class:	Fully Licensed
Restricted to:
CME Year:	0

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:
138TH AIR FORCE NATIONAL GUARD 9100 E 46TH ST N TULSA OK 74115 Phone #: (580) 541-6093 Fax #:

Name:	Type:	License Number:	Full/Part Time:
Primary Supervisor(s):
JASON MATTHEW LEINEN	MD	25158

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Oklahoma State Board of Medical Licensure and Supervision :: 101 NE 51st St, Oklahoma City, OK 73105-1821
Main Number: (405) 962-1400 :: Fax: (405) 962-1440 :: Complaints outside 405 area code: 1-800-381-4519
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