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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Tuesday, April 16, 2024 4:07 PM CDT
Next Update: Wednesday, April 17, 2024 2:50 AM CDT

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WEST, LISA DANETTE
Practice Address: CLASSEN FAMILY MEDICINE
1015 S.W. 4TH STREET ST
MOORE OK 73160

Address last updated on 3/19/2024
Phone #: (405) 378-2001
Fax #: (405) 445-7660
County: CLEVELAND
License: 1163
Dated: 4/1/2002
Expires: 3/31/2025
Temp. Ltr. Issued: 12/13/2001
Temp. Ltr. Expires: 3/31/2002
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:
CLASSEN FAMILY MEDICINE
1015 S.W. 4TH STREET ST
MOORE OK 73160

Phone #: (405) 378-2001
Fax #: (405) 445-7660

Hospital Privileges:

None listed

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
RANDALL L KEMP DO 2875
STEPHEN KOVACS DO 3860
RODNEY MCCRORY DO 2750
DOUGLAS RYAN RIDDLE MD 23957

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