Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 1
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
Anesthesiology
C. Scott Anthony, D.O.
6802 S Olympia Ave Ste 100 Tulsa, OK74132-1823
pain management - all body parts
[email protected] Contact: Jan Phone: (918) 513-3226 Fax: (918) 447-9308
City of Exam
Tulsa
Excl. Body Parts/Svcs: None American Board of Anesthesiology T
Anesthesiology
Emad Attallah-Wasif, M.D. Contact: Christina Phone: (918) 935-3240 Fax: ( )
2811 E 15th Street Suite 102 Tulsa, OK74104
pain management
Tulsa
American Board of Anesthesiology T
Anesthesiology
Blake Christensen, D.O.
Contact: Jeniffer Phone: (405) 286-9820 Fax: ( )
14100 Parkway Commons Dr Suite 100 Oklahoma City, OK73134
All, intervential pain management
Oklahoma City
Excl. Body Parts/Svcs: Heart, Kidneys, Liver, Lungs, GI Certification Unknown T R MITF
Anesthesiology
Frank J. Hackl, M.D.
7901 S Sheridan Tulsa, OK74133
Pain Management
Contact: Phone: (918) 710-4112 Fax: (918) 710-4118 American Board of Anesthesiology Pain Medicine T
* Physician has multiple specialties.
Tulsa
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 2
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
Anesthesiology
Gerald R. Hale, D.O.
2448 E 81 Ste 363 Tulsa, OK74137
pain management
[email protected] Contact: Brenda Phone: (918) 477-5943 Fax: ( )
City of Exam
Tulsa
Excl. Body Parts/Svcs: all except pain management cases American Osteopathic Board of Anesthesiology & Pain Management T
Anesthesiology
Daniel G. Morris, D.O.*
4110 S 100th East Ave Suite 201 Tulsa, OK74146
Pain Management Only
Tulsa
Contact: scheduling Phone: (918) 857-7246 Fax: (918) 359-5828 American Osteopathic Board of Anesthesiology-Pain Management T Anesthesiology
Jayen H. Patel, M.D.
[email protected] Contact: appt desk Phone: (918) 935-3240 Fax: (918) 935-3241
2811 E 15 Street Ste 102 Tulsa, OK 7410-4
pain management, neck, back, extremities, nervous system, headache, joints, fractures Excl. Body Parts/Svcs: PTSD, psychological trauma American Board of Anesthesiology T R MITF
* Physician has multiple specialties.
Tulsa
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 3
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
Anesthesiology
Terrell R. Phillips, D.O.
401 SW 80 Street Ste 200 Oklahoma City, OK73139
Pain Management
[email protected] Contact: Tammy Phone: (405) 601-4227 Fax: (405) 601-4237
City of Exam
Oklahoma City
Excl. Body Parts/Svcs: none within specialty American Osteopathic Board of Anesthesiology T R MITF
Anesthesiology
Justin Porter, M.D.
3601 NW 138 Street Ste 200 Oklahoma City, OK73134
[email protected] Contact: Neile Phone: (405) 242-4100 Fax: (405) 775-9356
Pain Management - head, neck,back
Oklahoma City
Excl. Body Parts/Svcs: pelvic pain, vaginal pain, rectal pain Certification Unknown T
Anesthesiology
Adam J. Wallace, M.D.
[email protected] Contact: Angelia, Julie Phone: (918) 447-9300 Fax: (918) 447-9308
6802 S Olympia Ave Ste 100 Tulsa, OK74132
pain management
Tulsa
Excl. Body Parts/Svcs: none Certification Unknown T
* Physician has multiple specialties.
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 4
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
Anesthesiology
Kalvin L. White, D.O.
6802 S Olympia Avenue Ste 100 Tulsa, OK74132-1823
Pain Management Only
City of Exam
Tulsa
[email protected] Contact: Angelia Phone: (918) 513-3231 Fax: (918) 447-9308 Am Board of Anesiology T Anesthesiology
Traci L. White, M.D.
6802 S Olympia Avenue Ste 100 Tulsa, OK73132-1923
Pain Management Only
Tulsa
Contact: Buffy Phone: (918) 513-3225 Fax: (918) 447-9308 American Board of Anesthesiology/Pain Medicine T Chiropractic
Michael A. Chiaffitelli, D.C.
10001 S Penn Bldg P Ste 170 Oklahoma City, OK73159
all chiropractics - spine
Oklahoma City
Excl. Body Parts/Svcs: all but spine
Contact: Alisha Phone: (405) 681-2273 Fax: (405) 681-2274
Certification Unknown T Chiropractic
Seyoung Kim, D.C.
[email protected] Contact: Kristin or Angie Phone: (405) 942-4040 Fax: (405) 773-4267
3435 NW 50th St. Oklahoma City, OK73112
spine (neck, back), hand
Oklahoma City
Excl. Body Parts/Svcs: None Certification Unknown T
* Physician has multiple specialties.
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 5
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
Chiropractic
C. Keith Muse, D.C.
6825 S Western Ave Oklahoma City, OK73139
neuromusculoskeletal
City of Exam
Oklahoma City
Excl. Body Parts/Svcs: None
Contact: Peggy Phone: (405) 634-1127 Fax: (405) 634-1177
Certification Unknown T R MITF Chiropractic
Jim R. Muse, D.C.
6825 S Western Oklahoma City, OK73139
Spine, Extermities
Oklahoma City
[email protected] Contact: Amber, Peggy Phone: (405) 634-1127 Fax: (405) 634-1177 Certification Unknown TR Chiropractic
James Daniel Post, D.C.
4141 NW Expressway Ste 180 Oklahoma City, OK73116
all chiropractics-spine
Oklahoma City
[email protected] Contact: Rhonda, Cathy Phone: (405) 840-8900 Fax: (405) 840-8990 Certification Unknown T
* Physician has multiple specialties.
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 6
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
Chiropractic
Troy A. Sturgill, D.C.
PO Box 335 Woodward, OK73802
musculoskeletal
[email protected] Contact: self Phone: (580) 256-1555 Fax: (580) 256-3370
City of Exam
Woodward
Excl. Body Parts/Svcs: internal orangs, brain, eyes, mouth and throat Certification Unknown T R MITF
Chiropractic
Steve Sweeney, D.C.
[email protected] Contact: Misty Phone: (405) 672-4800 Fax: ( )
211 S. Sooner Rd. Midwest City, OK73110
Spine, upper and lower extremities
Midwest City
Excl. Body Parts/Svcs: Cardiovascular, Pulmonary, Digestive Hematopoietic
-
Certification Unknown TR Chiropractic
Ronald B. Tripp, D.C.
[email protected] Contact: Sherri Phone: (405) 321-8530 Fax: (405) 321-1478
2400 Tee Circle Norman, OK73069
neck and back
Norman
Excl. Body Parts/Svcs: internal medicine Certification Unknown T R MITF
* Physician has multiple specialties.
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 7
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
Chiropractic
David B. Waggoner, D.C.
7000 NW Expressway Ste H Oklahoma City, OK73132
chiropractic
[email protected] Contact: Meaghan Phone: (405) 773-1113 Fax: ( )
City of Exam
Oklahoma City
Excl. Body Parts/Svcs: non-musculoskeletal Certification Unknown T MITF
Dentistry
Steven W. Hogg, D.D.S.
423 W Washington St Broken Arrow, OK74012
[email protected] Contact: Mary Phone: (918) 455-8899 Fax: (918) 362-9997
mouth, teeth, jaw
Broken Arrow
Excl. Body Parts/Svcs: None Certification Unknown T R MITF
Dentistry
Sterling H. Stalder, D.D.S
930 SW 107 Street Oklahoma City, OK73170
[email protected] Contact: Renee/ Jenae Phone: (405) 634-7303 Fax: (405) 634-7868
mouth and teeth
Oklahoma City
Excl. Body Parts/Svcs: none Certification Unknown T
Family Medicine
Ken Bowlware, D.O.
Contact: Amy Phone: (405) 600-1411 Fax: ( )
14024 Quail Pointe Dr. Oklahoma City, OK73134
all Excl. Body Parts/Svcs: none
American Board of Family Medicine TR
* Physician has multiple specialties.
OKC
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 8
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
Family Medicine
John Ellis, MD
5100 N Brookline Ave #465 Oklahoma City, OK73112
Occupational & Legal Medicine, Entire Body
[email protected] Contact: Kelly Phone: (405) 917-5336 Fax: ( )
City of Exam
OKC
Excl. Body Parts/Svcs: eyes
-
American Board of Family Medicine T R MITF Family Medicine
Jason M. Leinen, M.D.*
3115 SW 89 Street Oklahoma City, OK73159
[email protected] Contact: Amy Phone: (405) 600-1411 Fax: (405) 600-1531
all family & sports medicine, pain management (evaluate all body parts)
Oklahoma City
Excl. Body Parts/Svcs: none American Board of Family Medicine T
Family Medicine
Steve Randall, M.D.
[email protected] Contact: Kendra Phone: (405) 733-8000 Fax: ( )
3400 S Douglas Blvd Suite 302 Oklahoma City, OK73150
Interventional Pain Management Excl. Body Parts/Svcs: Fibromyalgia
Intervential Pain Management and Family Medicine TR
* Physician has multiple specialties.
Oklahoma City
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 9
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
Family Medicine
Michael L. Winzenread, M.D.
105 S Bryant Ste 310 Edmond, OK73034
all
Contact: Kari Phone: (405) 757-5211 Fax: ( )
City of Exam
Edmond
Excl. Body Parts/Svcs: None American Board of Family Practice R MITF
Family Practice
Daniel G. Morris, D.O.*
4110 S 100th East Ave Suite 201 Tulsa, OK74146
Pain Management Only
Tulsa
Contact: scheduling Phone: (918) 857-7246 Fax: (918) 359-5828 American Osteopathic Board of Anesthesiology-Pain Management T Family Practice
Lance E. Rosson, D.O. NONE Contact: Sharon Phone: (405) 236-1900 Fax: (405) 236-0362
1211 N Shartel Ste 1104 Oklahoma City, OK73103
all Excl. Body Parts/Svcs: None American Board of Family Physicians T R MITF
* Physician has multiple specialties.
Oklahoma City
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 10
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
City of Exam
General Surgery
Russell L. Hanan, Jr., M.D.
608 NW 9 Ste 5010 Oklahoma City, OK73102
general surgery hernias, intestines, soft tissue
Oklahoma City
none Contact: Debbie Smith Phone: (405) 235-3245 Fax: (405) 235-6991
Excl. Body Parts/Svcs: head, neck, spine, pulmonary Certification Unknown T
Hand Surgery
Mehdi N. Adham, M.D.*
8100 S Walker Ave Bldg A Oklahoma City, OK73139
Contact: Alice Phone: (405) 632-4468 Fax: (405) 632-4317
plastic & reconstructive surgery of hands and wrists Excl. Body Parts/Svcs: all except plastic surgery of hands/wrists
Oklahoma City
American Board of Plastic Surgery & Am Bd Plastic Surg of Hand T R MITF Hand Surgery
Carolyn Berg, MD
Contact: Pam Phone: (918) 994-4000 Fax: ( )
9709 E 79th Street South Tulsa, OK74133
Hands, Wrists, Forearm
Tulsa
Excl. Body Parts/Svcs: all but listed American Board of Surgery TR
* Physician has multiple specialties.
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 11
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
City of Exam
Hand Surgery
James F. Bischoff, M.D.*
6475 S Yale Ave Ste 301 Tulsa, OK74136-7824
hands, wrists
Tulsa
[email protected] Contact: Damita Carter 918-481-7658 Phone: (918) 494-9300 Fax: (918) 494-9397
Excl. Body Parts/Svcs: spine, elbows, shoulders, feet, ankles, knees, hips, rate only cases American Board of Orthopedic Surgery TR
Hand Surgery
Brian Chalkin, D.O.*
1809 E 13 St Ste 100 Tulsa, OK74104
[email protected] Contact: Rae Phone: (918) 582-6800 Fax: (918) 301-4293
Shoulder, Elbow, Hand, Wrist
Tulsa
Excl. Body Parts/Svcs: Knee, Ankle, Hip, Spine, Neck, Pelvis American Osteopathic Board of Orthopedic Surgery TR
Hand Surgery
Michael B. Clendenin, M.D. NONE Contact: Sheila Phone: (918) 749-1418 Fax: (918) 749-6241
2000 S Wheeling Ste 900 Tulsa, OK74104
hands and wrists only Excl. Body Parts/Svcs: all except hands and wrists American Board of Orthopedic Surgery TR
* Physician has multiple specialties.
Tulsa
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 12
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
City of Exam
Hand Surgery
Tom W. Ewing, D.O.
1020 24 Ave NW Ste 100 Norman, OK73069
hands
Norman
[email protected] Contact: Melissa or Dana Phone: (405) 447-4999 Fax: (405) 447-5608
Excl. Body Parts/Svcs: all except hands American Osteopathic Board of Orthopedic Surgery TR
Hand Surgery
Joel L. Frazier, M.D.* Contact: eRNEST Phone: (405) 631-4263 Fax: ( )
1044 SW 44 St Ste 600 Oklahoma City, OK73109 -
hands, upper extremities, elbows, wrists Excl. Body Parts/Svcs: all except hands, elbows, wrists
Oklahoma City
American Board of Orthopedic Surgery TR Hand Surgery
Charles H. Funderburk, M.D.*
[email protected] Contact: Lori Phone: (405) 230-9270 Fax: (405) 522-9474
1110 N Lee Oklahoma City, OK73103-2612
hands, shoulders, elbows, knees, wrists, forearm Excl. Body Parts/Svcs: neck, back, hips, feet American Board of Orthopedic Surgery TR
* Physician has multiple specialties.
Oklahoma Ctiy, Edmond
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 13
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
City of Exam
Hand Surgery
Greg Halko, M.D.*
3301 NW 50 Oklahoma City, OK73112
hands, upper extremities
Oklahoma City
[email protected] Contact: central scheduling Phone: (405) 947-0911 Fax: (405) 942-5043
Excl. Body Parts/Svcs: spine, (neck, back) and lower extremities American Board of Orthopedic Surgery T R MITF
Hand Surgery
Daron C. Hitt, M.D.
3115 SW 89 Street Oklahoma City, OK73159
hands only
Oklahoma City
Excl. Body Parts/Svcs: none
Contact: Amy Phone: (405) 424-5630 Fax: (405) 692-1632
American Board of Surgery TR Hand Surgery
Thomas C. Howard, M.D.*
[email protected] Contact: Lori Phone: (405) 230-9270 Fax: (405) 230-9424
1110 N Lee Oklahoma City, OK73103-2612
hands, shoulders, knees, hips and feet Excl. Body Parts/Svcs: spine, (neck,back) American Board of Orthopedic Surgery TR
* Physician has multiple specialties.
Oklahoma City, Norman
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 14
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
City of Exam
Hand Surgery
Stephen W. Mihalsky, M.D.
105 S Bryant Ste 407 Edmond, OK73034
all within specialty
Midwest City, Edmond
Excl. Body Parts/Svcs: shoulders, neck
Contact: Donna Elswick Phone: (405) 348-5060 Fax: (405) 364-8750
American Board of Surgery of the Hand, American Board of Surgery TR Hand Surgery
David B. Mokhtee, M.D.
4802 S. 109th E. Ave. Tulsa, OK74146
fingers to elbows
Tulsa
Excl. Body Parts/Svcs: Everything except Hand and Wrist
Contact: Latoya Phone: (918) 392-1400 Fax: (918) 392-1401
American Board of Surgery - Hand Surgery T Hand Surgery
M. Sean O'Brien, D.O.*
Contact: Marilyn Phone: (405) 759-2663 Fax: ( )
3110 SW 89th St., Suite 200C Oklahoma City, OK73159
Hands and Shoulders Excl. Body Parts/Svcs: back, neck, feet
American Osteopathic Board of Orthopedic Surgery T
* Physician has multiple specialties.
Oklahoma City
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 15
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
City of Exam
Hand Surgery
Ghazi M. Rayan, M.D.*
3366 NW Expressway Ste 700 Oklahoma City, OK73112-4418
shoulder, elbow, wrist, hand
Oklahoma City
Excl. Body Parts/Svcs: back
Contact: Phone: (405) 945-4888 Fax: (405) 945-4887
American Board of Orthopedic Surgery/ Am Bd of Ortho Surg of Hand T R MITF Hand Surgery
Richard A. Ruffin, M.D.*
3301 NW 50 Oklahoma City, OK73112-5691
hands, wrists, elbows, shoulders
Oklahoma City
Excl. Body Parts/Svcs: neck & back (spine), feet, knees
Contact: Central Scheduling Phone: (405) 947-0911 Fax: (405) 947-4263
American Board of Orthopedic Surgery, Hand Surgery T Hand Surgery
Houshang Seradge, M.D.* Contact: Misti Phone: (405) 634-4263 Fax: ( )
1044 SW 44 Street Suite 518 Oklahoma City, OK73109
spine, foot, wrist, elbow, shoulder, hip, knee, ankle
American Board of Orthopedic Surgery T R MITF
* Physician has multiple specialties.
Oklahoma City
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 16
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
City of Exam
Hand Surgery
Garrett Watts, M.D.
10507 E 91st Street Suite 350 Tulsa, OK74133
hands, wrists, elbows
Broken Arrow
[email protected] Contact: Central States Orthopedic Phone: (918) 451-3000 Fax: (918) 451-2700
Excl. Body Parts/Svcs: spine, neck, lower extremities American Board of Orthopedic Surgery T R MITF
Internal Medicine
S.A. Chaudry, M.D.
5611 Mosteller Dr Oklahoma City, OK73112
[email protected] Contact: Cheryl Phone: (405) 843-2345 Fax: (405) 843-8237
all internal medicine - whole body
Oklahoma City
Excl. Body Parts/Svcs: None American Board of Internal Medicine TR
Internal Medicine
Kent C. Hensley, M.D.*
9433 N Kelley Ave Oklahoma City, OK73131
NONE Contact: Yvonne, Leslie Phone: (405) 840-6720 Fax: (405) 840-6723
all
Oklahoma City
Excl. Body Parts/Svcs: psychiatric American Board of Internal Medicine R MITF
Internal Medicine
A. E. Moorad, M.D.*
4221 S Western Ste 3010 Oklahoma City, OK73109
all PM & R, pain managment
Contact: Marilyn Phone: (405) 636-7450 Fax: (405) 631-2296 American Board of Internal Medicine T R MITF * Physician has multiple specialties.
Oklahoma City
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 17
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
City of Exam
Internal Medicine
Kenneth R. Trinidad, D.O.*
1006 W 23 St Tulsa, OK74107
all
Tulsa
Excl. Body Parts/Svcs: Lungs
Contact: Rhonda Phone: (918) 742-4881 Fax: (918) 742-5854
Internal Medicine T R MITF Neurology
Gabriel Pitman, D.O.
[email protected] Contact: Paula Byrd Phone: (405) 632-9090 Fax: ( )
401 SW 80 STE 201 Oklahoma City, OK73139
all within neurology specialty
Oklahoma City
Excl. Body Parts/Svcs: abdomen, chest American Board of Neurology T
Neurology
W. Dean Shipley, M.D.
[email protected] Contact: Kelly Phone: (405) 302-2661 Fax: (405) 302-2670
4120 W Memorial Rd Ste 218 Oklahoma City, OK73120
nervous system only/adult nerology Excl. Body Parts/Svcs: neuological IME's only American Board of Psychiatry and Neurology T
* Physician has multiple specialties.
Oklahoma City
Date: 01/19/2017 Time: 08:45
Specialty
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017 Physician/Contact Info
Neuropsychology - Clinical Russell L. Adams, Ph.D.*
Page: 18
Mailing Address
Body Parts/Type of Services/ Board Certified
City of Exam
PO Box 26901 WP3440 Oklahoma City, OK73126
brain, pain management, psychological overlay
Oklahoma City
Contact: Gary Phone: (405) 271-8001 Fax: (405) 271-8802 American Board of Professional Psychology/Clinical Neuropsych TR Neuropsychology - Clinical Michael R. Basso, Ph.D.*
[email protected] Contact: Dr. Basso Phone: (918) 631-3151 Fax: (918) 631-2833
Univ of Tulsa Dept of Psychology 800 S Tucker Drive Tulsa, OK74104
head/brain - diatnostic testing, psychological overlay
Tulsa
Excl. Body Parts/Svcs: None ABPP - Clinical Neuropsychology R MITF
Neuropsychology
Faust Bianco, Jr., Ph.D.*
Contact: Suzan Phone: (918) 746-0794 Fax: (918) 746-0717
7146 S Braden Ave Ste 500 Tulsa, OK74136
Rehabilitation (nervous system, whole body) Trauma Related Disorders (pain stress, depression, brain) Excl. Body Parts/Svcs: none Certification Unknown T R MITF
* Physician has multiple specialties.
Tulsa
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 19
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
Neuropsychology
Douglas O. Brady, Ph.D.*
1401 SW Park Ridge Blvd Ste D Lawton, OK73505
Brain; Back (Spine); Chronic pain issues multiple sites
City of Exam
Lawton
[email protected] Contact: D'Ann Smith Phone: (580) 355-7474 Fax: (580) 355-6765 American Board of Professional Disability T R MITF Neuropsychology
David E. Hansen, Ph.D.
5512 S Lewis Ave Ste 8 Tulsa, OK74105
[email protected] Contact: Emge Phone: (918) 712-9004 Fax: (918) 712-9120
neuropsychology/brain
Tulsa
Excl. Body Parts/Svcs: None Certification Unknown R MITF
Neuropsychology
Terry G. Shaw, Ph.D.
[email protected] Contact: Mary Phone: (918) 488-6165 Fax: (918) 488-8021
7146 S Braden Ste 500 Tulsa, OK74136
head, brain, psychological overlay Excl. Body Parts/Svcs: all excluded except parts listed as specialty American Board of Professional Neuropsychology TR
* Physician has multiple specialties.
Tulsa
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 20
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
Neuropsychology
Adam G. Sherman, Ph.D.
3015 E Skelly Dr Ste 135 Tulsa, OK74105
all within specialty
[email protected] Contact: Susan Phone: (918) 712-2885 Fax: (918) 712-9019
City of Exam
Tulsa
Excl. Body Parts/Svcs: None Certification Unknown TR
Neurosurgery
Clinton J. Baird, M.D.
6802 S Olympia Ave Ste 350 Tulsa, OK74132
Contact: Sheila Phone: (918) 749-0762 Fax: (918) 744-4246
spine, brain, nerves, carpal tunnel, ulnar nerve, neurosurgery Excl. Body Parts/Svcs: hips, knees, joints
Tulsa
Certification Unknown TR Neurosurgery
Daniel Boedeker, M.D.
[email protected] Contact: Kim Phone: (918) 491-3512 Fax: (918) 491-3542
6767 S Yale Ave Ste A Tulsa, OK74136
brain, spine, peripheral nerve for carpal tunnel Excl. Body Parts/Svcs: all except specialty Certification Unknown TR
* Physician has multiple specialties.
Tulsa
Date: 01/19/2017 Time: 08:45
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Page: 21
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
Neurosurgery
Christopher G. Covington, M.D.
Attn: Sheila Harless 6802 S Olympia Ave Ste 300 Tulsa, OK74132
spine, brain, carpel tunnel
[email protected] Contact: Sheila, Jamie Phone: (918) 749-0762 Fax: (918) 744-4246
City of Exam
Tulsa
Excl. Body Parts/Svcs: extremities American Board of Neurological Surgery T
Neurosurgery
Joseph Bridger Cox, M.D.
[email protected] Contact: Ashley Phone: (405) 748-3300 Fax: ( )
4120 W. Memeorial Rd Oklahoma City, OK73120
Neck, Back, Wrist (carpal tunnel)
OKC
Excl. Body Parts/Svcs: Shoulders, Knees, lower extremities Certification Unknown T
Neurosurgery
Allan S. Fielding, M.D.
[email protected] Contact: any staff member Phone: (918) 294-0080 Fax: ( )
2000 S Wheeling Ste 1110 Tulsa, OK74104
-
head, neck, back, shoulder, hip, knee, CTS, ulnar neuropathy Excl. Body Parts/Svcs: Neurosurgical Cases Only American Board of Neurological Surgery T R MITF
* Physician has multiple specialties.
Tulsa
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 22
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
Neurosurgery
Emily D. Friedman, M.D.
3435 NW 56 Bldg A Ste 210 Oklahoma City, OK73112
brain, spine, neck, carpal tunnel
[email protected] Contact: Dana Phone: (405) 945-4900 Fax: (405) 945-4901
City of Exam
Oklahoma City
Excl. Body Parts/Svcs: all body parts not specified American Board of Neurological Surgery T
Neurosurgery
Eric S. Friedman, M.D.
4120 W Memorial Rd Ste 300 Oklahoma City, OK73120-9322
[email protected] Contact: Kelsey Phone: (405) 748-3300 Fax: (405) 749-1671
brain and carpal tunnel only
Oklahoma City
Excl. Body Parts/Svcs: spine, shoulders, knees, lower extremities American Board of Neurological Surgery T
Neurosurgery
Steven E. Gaede, M.D.
[email protected] Contact: Sheila,Melissa Phone: (918) 749-0762 Fax: (918) 744-4246
6802 S Olympia Ave Ste 300 Tulsa, OK74132
spine, brain, carpal tunnel, ulnar nerve Excl. Body Parts/Svcs: non-spine orthopedic cases American Board of Neurological Surgery T
* Physician has multiple specialties.
Tulsa
Date: 01/19/2017 Time: 08:45
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Page: 23
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
Neurosurgery
Michael Hahn, M.D.
4120 W Memorial Rd Ste 300 Oklahoma City, OK73120
spine (neck, back), wrist (carpal tunnel)
[email protected] Contact: Tammy Phone: (405) 748-3300 Fax: (405) 749-1671
City of Exam
Oklahoma City
Excl. Body Parts/Svcs: shoulders, knees, hips, elbows American Board of Neurological Surgery T
Neurosurgery
Brent N. Hisey, M.D.
14100 Parkway Commons Dr Ste 201 Oklahoma City, OK73134
[email protected] Contact: Alisha Phone: (405) 242-4720 Fax: (405) 242-4933
spine (neck, back), brain, carpal tunnel
Oklahoma City
Excl. Body Parts/Svcs: all except specialty American Board of Neurological Surgery T R MITF
Neurosurgery
Donald D. Horton, M.D.
[email protected] Contact: Marie, Alisha Phone: (405) 242-4720 Fax: (405) 242-4765
14100 Parkway Commons Dr Ste 201 Oklahoma City, OK73134
spinal surgery (cervical/lumbar) carpal tunnel Excl. Body Parts/Svcs: Nothing outside of cervical, lumbar, brain or carpal tunnel American Board of Neurological Surgery T R MITF
* Physician has multiple specialties.
Oklahoma City
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 24
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
Neurosurgery
Kyle Mangels, M.D.
6802 S Olympia Ave Ste 300 Tulsa, OK74132
neurological surgery spine, brain, carpal tunnel. ulnar nerve
[email protected] Contact: Sheila, Jamie Phone: (918) 749-0762 Fax: (918) 744-4246
City of Exam
Tulsa
Excl. Body Parts/Svcs: hips, knees, joints American Board of Neurological Surgery TR
Neurosurgery
John S. Marouk, D.O.
2128 S Atlanta PL Ste 100 Tulsa, OK74114
[email protected] Contact: Phone: (918) 583-5131 Fax: (918) 592-0670
spine, brain only
Tulsa
Excl. Body Parts/Svcs: all other body parts American Osteopathic Board of Surgery T
Neurosurgery
Fadi F Nasr, M.D.
[email protected] Contact: Stephanie Phone: (405) 748-3300 Fax: ( )
4120 W Memorial Rd, Ste 300 Oklahoma City, OK73120
-
Spine (neck, back), wrist (carpal tunnel) Excl. Body Parts/Svcs: shoulders, knees, hips, elbows American Board of Neurological Surgery T
* Physician has multiple specialties.
Oklahoma City
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 25
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
Neurosurgery
Stan Pelofsky, M.D.
4120 W Memorial Rd Ste 300 Oklahoma City, OK73120
neck, back, wrist (carpal tunnel)
[email protected] Contact: Angie Phone: (405) 748-3300 Fax: (405) 748-2920
City of Exam
Oklahoma City
Excl. Body Parts/Svcs: shoulders, knees, lower extremities American Board of Neurological Surgery T
Neurosurgery
Ryan F. Rahhal, M.D.
6767 S Yale Ave Ste A Tulsa, OK74136
[email protected] Contact: Kim Perry, Jacci Carpio Phone: (918) 492-7587 Fax: (918) 492-4033
brain, spine (thoracic, lumbar, & cervical), carpal tunnel
Tulsa
Excl. Body Parts/Svcs: all ot neurosurgical Certification Unknown TR
Neurosurgery
Robert L. Remondino, M.D.
[email protected] Contact: Linda Phone: (405) 748-3300 Fax: (405) 749-1671
4120 W Memorial Rd Ste 300 Oklahoma City, OK73120
neck, back, wrists (carpal tunnel) Excl. Body Parts/Svcs: shoulders, knees, lower extremities American Board of Neurological Surgery T
* Physician has multiple specialties.
Oklahoma City
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 26
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
Neurosurgery
W. Emery Reynolds, M.D.
4120 W Memorial Ste 208 Oklahoma City, OK73120
head, spine
City of Exam
Oklahoma City
NONE Contact: Sondra Phone: (405) 755-3540 Fax: (405) 755-7001 American Board of Neurological Surgery T Neurosurgery
James A. Rodgers, M.D.
6565 S Yale Ste 709 Tulsa, OK74136
cervical & lumbar spine carpal tunnel
Tulsa
Contact: Rita Phone: (918) 481-4965 Fax: (918) 481-4996 American Board of Neurological Surgery R Neurosurgery
Brian E. Snell, M.D.
[email protected] Contact: CALLIE Phone: (405) 748-3300 Fax: (405) 749-1671
4120 W Memorial Rd Ste 300 Oklahoma City, OK73120
spine (neck, back), wrist (carpal tunnel) Excl. Body Parts/Svcs: shoulders, knees, hips, elbows American Board of Neurological Surgery T
* Physician has multiple specialties.
Oklahoma City
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 27
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
Neurosurgery
Caple A Spence, M.D.
8121 National Ave Ste 210 Midwest City, OK73110
brain, spine, peripheral nerves
[email protected] Contact: Christy Phone: (405) 455-3393 Fax: (405) 455-7162
City of Exam
MWC
Excl. Body Parts/Svcs: all except brain, spine, peripheral nerves American Board of Neurological Surgery T
Neurosurgery
Robert E. Tibbs, M.D.
4120 W Memorial Rd Ste 300 Oklahoma City, OK73120
Contact: Angie Phone: (405) 748-3300 Fax: (405) 748-1671
TREATMENT AUTHORIZATION for neck, Oklahoma City back, wrists (carpal tunnel) Excl. Body Parts/Svcs: shoulders, knees, lower extremities American Board of Neurological Surgery T
Neurosurgery
Frank J. Tomecek, M.D.
[email protected] &
[email protected] Contact: Sheila, Susie Phone: (918) 749-0762 Fax: (918) 749-8531
6802 S Olympia Ave Ste 300 Tulsa, OK74132
spine (neck, back), brain, carpal tunnel, ulner nerve Excl. Body Parts/Svcs: legs, hips American Board of Neurological Surgery TR
* Physician has multiple specialties.
Tulsa
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 28
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
Neurosurgery
Benjamin T. White, M.D.
4120 W Memorial Rd Ste 300 Oklahoma City, OK73120
neck, back, wrist (carpal tunnel)
[email protected] Contact: Kelsey Phone: (405) 748-3300 Fax: (405) 748-1671
City of Exam
Oklahoma City
Excl. Body Parts/Svcs: shoulders, knees, lower extremities American Board of Neurological Surgery T
Neurosurgery
Robert J. Wienecke, M.D.
4120 W Memorial Rd Ste 300 Oklahoma City, OK73120
neck, back, wrists{carpal tunnel)
Oklahoma City
Excl. Body Parts/Svcs: shoulders, knees, lower extremities
Contact: Marlea Phone: (405) 748-3300 Fax: (405) 748-1671
American Board of Neurological Surgery T Neurosurgery
Gregory L. Wilson, D.O.
9709 E 79 Street South Tulsa, OK74133
brain, neck, back
Tulsa
Contact: Pam Phone: (918) 994-4068 Fax: (918) 994-4095 Am Board of Osteopathic Neurological Surgery TR
* Physician has multiple specialties.
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 29
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
Occupational Medicine
William R. Gillock, M.D.
7170 S Braden Ste 175 Tulsa, OK74136
all body parts
[email protected] Contact: Sharon Phone: (918) 481-0994 Fax: (918) 494-6747
City of Exam
Tulsa
Excl. Body Parts/Svcs: none American Board of Internal Medicine & Preventive Medicine T R MITF
Occupational Medicine
John W. Hallford, D.O.
5682 W Skelly Dr Tulsa, OK74107
[email protected] Contact: Julie Phone: (918) 446-1891 Fax: (918) 446-1894
occupational medicine/urgent care
Tulsa
Excl. Body Parts/Svcs: none American Osteopathic Board of Family Physicians T R MITF
Occupational Medicine
Kent C. Hensley, M.D.* NONE Contact: Yvonne, Leslie Phone: (405) 840-6720 Fax: (405) 840-6723
9433 N Kelley Ave Oklahoma City, OK73131
all Excl. Body Parts/Svcs: psychiatric American Board of Internal Medicine R MITF
* Physician has multiple specialties.
Oklahoma City
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 30
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
Occupational Medicine
Andrew C. John, M.D.
4323 NW 63 Street Ste 105 Oklahoma City, OK73116
all occupational medicine
[email protected] Contact: Jerri Phone: (405) 843-0610 Fax: (405) 843-0620
City of Exam
Oklahoma City
Excl. Body Parts/Svcs: Psychological/Psychiatric Certification Unknown R MITF
Occupational Medicine
William D. Jones, M.D.
707 NW 13 St Oklahoma City, OK73103
[email protected] Contact: Jeanne Phone: (405) 521-8604 Fax: (405) 521-8605
all occupational medicine (rating only)
Oklahoma City
Excl. Body Parts/Svcs: female reproductive system Certification Unknown R MITF
Occupational Medicine
John A. Munneke, M.D.
[email protected] Contact: JoAnne, Kerri Phone: (405) 755-9702 Fax: (405) 755-9718
36 W Memorial Ste B9 Oklahoma City, OK73114
all including occupational medicine, MITF, Form 3, pain management Excl. Body Parts/Svcs: eyes Certification Unknown T R MITF
* Physician has multiple specialties.
Oklahoma City, Tulsa
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 31
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
Occupational Medicine
Robert Paul, M.D.
6717 S Yale Ave Suite 107 Tulsa, OK74136
all within specialty
Contact: Linda Phone: (918) 496-1991 Fax: ( )
City of Exam
Tulsa
Certification Unknown R MITF
Occupational Medicine
Carl B. Pettigrew, D.O.
1211 N Shartel Ste 500 Oklahoma City, OK73103
[email protected] Contact: Karen Phone: (405) 239-7766 Fax: (405) 235-4895
all
Oklahoma City, Tulsa
Excl. Body Parts/Svcs: None Certification Unknown T R MITF
Occupational Medicine
J. A. Snelling, D.O. none Contact: Margaret Phone: (918) 749-3187 Fax: (918) 491-9925
PO Box 702738 Tulsa, OK74170
Spine, Musculoskeletal Excl. Body Parts/Svcs: Cardiac-Respiratory American Board of Family Physicians, Am Board of Preventive Med. R
* Physician has multiple specialties.
Tulsa
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 32
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
City of Exam
Occupational Medicine
Kenneth R. Trinidad, D.O.*
1006 W 23 St Tulsa, OK74107
all
Tulsa
Excl. Body Parts/Svcs: Lungs
Contact: Rhonda Phone: (918) 742-4881 Fax: (918) 742-5854
Internal Medicine T R MITF Occupational Medicine
Mark Stephen Wilson, M.D.*
5522 S Lewis Tulsa, OK74105
Contact: TU-Sandra, OKC-Tayller Phone: (918) 488-8285 Fax: (405) 949-1801
all orthopedics, continuing medical maintenance Excl. Body Parts/Svcs: None
Tulsa, OKC
Certification Unknown T R MITF Orthopedic Surgery
Kasra Ahmadinia, M.D.
[email protected] Contact: Wendy Phone: (918) 494-9300 Fax: ( )
6475 S. Yale Ave Suite 301 Tulsa, OK74136
-
Spine - back and neck
Tulsa
Excl. Body Parts/Svcs: Shoulder, Elbow, Wrist, Hand, Knee, Hip, Foot, Ankle Certification Unknown TR
* Physician has multiple specialties.
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 33
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
City of Exam
Orthopedic Surgery
Gary B. Anderson, M.D.*
3301 NW 50 St Oklahoma City, OK73112
knees, shoulders, hips, elbows
Oklahoma City
[email protected] Contact: Scheduling Phone: (405) 947-0911 Fax: (405) 947-0775
Excl. Body Parts/Svcs: spine (back, neck), hands American Board of Orthopedic Surgery T R MITF
Orthopedic Surgery
John W. Anderson, M.D.
3301 NW 50 St Oklahoma City, OK73112
[email protected] Contact: Central Scheduling Phone: (405) 947-0911 Fax: (405) 948-5177
foot and ankle
Oklahoma City
Excl. Body Parts/Svcs: spine (neck, back) and upper extremities American Board of Orthopedic Surgery T R MITF
Orthopedic Surgery
Clint Justin Basener, D.O.*
[email protected] Contact: Pam Phone: (918) 994-4068 Fax: (918) 994-4095
9709 E 79 Street S Tulsa, OK74133-4566
all within specialty
Tulsa
Excl. Body Parts/Svcs: All except brain, neck, spine Certification Unknown TR
* Physician has multiple specialties.
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 34
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
Orthopedic Surgery
Jaafar M. Bazih, M.D.
4802 S 109 E Ave Tulsa, OK74146
extremities, hands
City of Exam
Tulsa
Excl. Body Parts/Svcs: spine: back & neck
Contact: Denise Phone: (918) 392-1400 Fax: (918) 392-1401
American Board of Orthopedic Surgery T Orthopedic Surgery
James F. Bischoff, M.D.*
6475 S Yale Ave Ste 301 Tulsa, OK74136-7824
[email protected] Contact: Damita Carter 918-481-7658 Phone: (918) 494-9300 Fax: (918) 494-9397
hands, wrists
Tulsa
Excl. Body Parts/Svcs: spine, elbows, shoulders, feet, ankles, knees, hips, rate only cases American Board of Orthopedic Surgery TR
Orthopedic Surgery
David Bobb, M.D.
[email protected] Contact: Donna Phone: (405) 364-8855 Fax: ( )
825 E Robinson Norman, OK73071
all except back & head Excl. Body Parts/Svcs: back & head
American Board of Orthopaedic Surgery T R MITF
* Physician has multiple specialties.
Norman
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 35
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
Orthopedic Surgery
James Lee Bond, M.D.
3400 W Tecumseh Rd Ste 101 Norman, OK73072
knees, shoulders, elbows, hands
[email protected] Contact: BROOKE Phone: (405) 517-3719 Fax: (405) 360-6769
City of Exam
Norman
Excl. Body Parts/Svcs: hips, back, foot, ankle American Board of Orthopaedic Surgery MITF
Orthopedic Surgery
Bradford Boone, M.D.*
6475 S Yale Ave Ste 301 Tulsa, OK74136-7824
[email protected] Contact: Wendy Phone: (918) 494-9300 Fax: (918) 494-9397
knees, shoulders, elbows
Tulsa
Excl. Body Parts/Svcs: spine, hips, feet, ankles, hands & rate only cases American Board of Orthopedic Surgery/Sports Medicine TR
Orthopedic Surgery
R. Tyler Boone, M.D.
[email protected] Contact: Lori Phone: (918) 494-9300 Fax: (918) 494-9397
6475 S Yale Ave Ste 301 Tulsa, OK74136-7824
neck, back Excl. Body Parts/Svcs: hands, hips, knees, feet, ankles shoulders, elbows, no rate only cas American Board of Orthopedic Surgery/AmBd Ortho Surg of the Spine TR
* Physician has multiple specialties.
Tulsa
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 36
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
Orthopedic Surgery
Steven P. Brantley, M.D.
3301 NW 50th Street Oklahoma City, OK73112
knees and shoulders
[email protected] Contact: central scheduling Phone: (405) 947-0911 Fax: ( )
City of Exam
Oklahoma City
Excl. Body Parts/Svcs: Spine (neck and back) Certification Unknown T
Orthopedic Surgery
Christopher A. Browne, M.D.
6475 S Yale Ave Ste 301 Tulsa, OK74136-7824
[email protected] Contact: Lori Phone: (918) 494-9300 Fax: (918) 494-9397
hips, knees
Tulsa
Excl. Body Parts/Svcs: hands, spine, feet, ankles, shoulders, elbows, no rate only cases American Board of Orthopedic Surgery TR
Orthopedic Surgery
James D. Cash, M.D.*
[email protected] Contact: Phone: (918) 481-2767 Fax: (918) 481-7611
6585 S Yale Ave Ste 200 Tulsa, OK74136
knees, shoulders Excl. Body Parts/Svcs: none American Board of Orthopedic Surgery T R MITF
* Physician has multiple specialties.
Tulsa
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 37
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
City of Exam
Orthopedic Surgery
Brian Chalkin, D.O.*
1809 E 13 St Ste 100 Tulsa, OK74104
Shoulder, Elbow, Hand, Wrist
Tulsa
[email protected] Contact: Rae Phone: (918) 582-6800 Fax: (918) 301-4293
Excl. Body Parts/Svcs: Knee, Ankle, Hip, Spine, Neck, Pelvis American Osteopathic Board of Orthopedic Surgery TR
Orthopedic Surgery
Brian Clowers, M.D.
3400 W Tecumseh Ste 101 Norman, OK73072
[email protected] Contact: Brooke Phone: (405) 517-3719 Fax: (405) 360-6769
foot, ankle
OKC, Norman
Excl. Body Parts/Svcs: all except foot & ankle American Board of Orthopedic Surgery TR
Orthopedic Surgery
Ashley Cogar, M.D.
[email protected] Contact: Diana, Jennifer Phone: (405) 419-5665 Fax: (405) 419-5429
9800 Broadway Extension Suite 201 Oklahoma City, OK73114
elbow, wrist, hand
Oklahoma City
Excl. Body Parts/Svcs: spine, shoulder, hip, knee, ankle or foot Certification Unknown TR
* Physician has multiple specialties.
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 38
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
City of Exam
Orthopedic Surgery
Arthur Hobart Conley, III, M.D.
P O Box 891328 Oklahoma City, OK73189
(spine) back and neck only
Oklahoma City
[email protected] Contact: Sarita Phone: (405) 703-7306 Fax: (405) 703-7334
Excl. Body Parts/Svcs: all except spine American Board of Orthopedic Surgery T
Orthopedic Surgery
Jimmy Harold Conway, M.D.
10001 S Western Ste 101 Oklahoma City, OK73139-2997
[email protected] Contact: Nancy Phone: (405) 692-3749 Fax: (405) 692-3789
elbows, knees
Oklahoma City
Excl. Body Parts/Svcs: spine, feet, hands American Board of Orthopedic Surgery T R MITF
Orthopedic Surgery
Steven D. Coupens, M.D.
9800 Broadway Extension Suite 201 Oklahoma City, OK73114
all body parts
[email protected] Contact: Phone: (405) 427-6776 Fax: (405) 424-5415 American Board of Orthopedic Surgery T R MITF
* Physician has multiple specialties.
Oklahoma City
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 39
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
City of Exam
Orthopedic Surgery
Thomas G. Craven, M.D.
6585 S Yale Ste 200 Tulsa, OK74136
spine (neck, back)
Tulsa
[email protected] Contact: Melissa, Linda Phone: (918) 481-2767 Fax: (918) 481-7669
Excl. Body Parts/Svcs: hands, wrists, knees, ankles American Board of Orthopedic Surgery T R MITF
Orthopedic Surgery
Scott De La Garza, M.D.
608 NW 9 Street Ste 6000 Oklahoma City, OK73102
[email protected] Contact: Brooke Phone: (405) 517-3719 Fax: (405) 360-6769
spine only (lumbar, cervical, thorasic)
Oklahoma City
Excl. Body Parts/Svcs: all except spine American Board of Orthopaedic Surgery TR
Orthopedic Surgery
Kevin M. Dukes, M.D.
Contact: Denise Phone: (918) 392-1437 Fax: (918) 392-1401
4802 S 109 E Ave Tulsa, OK74146
shoulders Excl. Body Parts/Svcs: all but shoulder American Board of Orthopedic Surgery T
* Physician has multiple specialties.
Tulsa
Date: 01/19/2017 Time: 08:45
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Page: 40
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
City of Exam
Orthopedic Surgery
Ronald Matthew Dumigan, M.D.
1110 N Lee Oklahoma City, OK73103
Knees, Shoulders, Elbows, ankles,
Oklahoma City, Edmond, Norman
[email protected] Contact: Lori Phone: (405) 230-9270 Fax: (405) 230-9505
Excl. Body Parts/Svcs: Spine, Neck, Hip American Board of Orthopedic Surgery T
Orthopedic Surgery
Rory C. Dunham, D.O.
[email protected] Contact: Phone: (405) 759-2562 Fax: ( )
9060 Harmony Drive, Ste. B Midwest City, OK73130
hand, knee, shoulder, ankle, elbow, hip, feet, back
Midwest City
American Osteopathic Board of Orthopedic Surgery T
Orthopedic Surgery
Scott J. Dunitz, M.D.
Contact: Latoya Phone: (918) 392-1403 Fax: (918) 392-1401
4802 S 109 E Ave Tulsa, OK74146
hips, knees (adult reconstruction) Excl. Body Parts/Svcs: back, neck, hands American Board of Orthopedic Surgery TR
* Physician has multiple specialties.
Tulsa
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 41
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
Orthopedic Surgery
Eugene G. Feild, M.D.
6600 S Yale Ste 1315 Tulsa, OK74136-3346
all within specialty
City of Exam
Tulsa
[email protected] Contact: Nancy Phone: (918) 481-7770 Fax: (918) 481-7797 American Board of Orthopedic Surgery T R MITF Orthopedic Surgery
David J. Flesher, M.D.
3301 NW 50 St Oklahoma City, OK73112
[email protected] Contact: Central Scheduling Phone: (405) 947-0911 Fax: (405) 948-5177
knees, shoulders, hips, elbows
Oklahoma City
Excl. Body Parts/Svcs: spine (neck & back), feet, hands American Board of Orthopedic Surgery T
Orthopedic Surgery
Thomas H. Flesher, III, M.D.
[email protected] Contact: central scheduling Phone: (405) 947-0911 Fax: (405) 948-5171
3301 NW 50 St Oklahoma City, OK73112
shoulders, ankles, knees, hips Excl. Body Parts/Svcs: spine (back, neck), wrists, hands American Board of Orthopedic Surgery T
* Physician has multiple specialties.
Oklahoma City
Date: 01/19/2017 Time: 08:45
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Page: 42
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
Orthopedic Surgery
Winston Fong, M.D.
1110 N Lee Oklahoma City, OK73103
spine only (cervical, thoracic, lumbar)
[email protected] Contact: Lori Phone: (405) 230-9270 Fax: (405) 230-9421
City of Exam
OKC, Edmond
Excl. Body Parts/Svcs: all except spine (shoulders,elbows,hands,wrist,hips, knees,ankles/f American Board of Orthopaedic Surgery TR
Orthopedic Surgery
Dennis E. Foster, M.D.
3130 SW 89 St Ste 100 Oklahoma City, OK73159-7900
all
Oklahoma City
Excl. Body Parts/Svcs: None
Contact: Phone: (405) 378-4472 Fax: (405) 378-3580
American Board of Orhtopedic Surgery T R MITF Orthopedic Surgery
Jeff A. Fox, M.D.*
Contact: appt desk Phone: (918) 481-7658 Fax: (918) 481-7611
6585 S Yale Ave Ste 200 Tulsa, OK74136
knees, ankles, elbow, shoulders Excl. Body Parts/Svcs: hand, spine American Board of Orthopedic Surgery T R MITF
* Physician has multiple specialties.
Tulsa
Date: 01/19/2017 Time: 08:45
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Page: 43
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
City of Exam
Orthopedic Surgery
Sami R. Framjee, M.D.
2000 S Wheeling Ave Ste 1110 Tulsa, OK74104
spine and general orthopaedics
Tulsa (Treat only) and Oklahoma City
[email protected] Contact: Teri Phone: (918) 294-0080 Fax: (918) 742-2119
Excl. Body Parts/Svcs: None American Board of Orthopedic Surgery T R MITF
Orthopedic Surgery
Joel L. Frazier, M.D.* Contact: eRNEST Phone: (405) 631-4263 Fax: ( )
1044 SW 44 St Ste 600 Oklahoma City, OK73109 -
hands, upper extremities, elbows, wrists Excl. Body Parts/Svcs: all except hands, elbows, wrists
Oklahoma City
American Board of Orthopedic Surgery TR Orthopedic Surgery
Charles H. Funderburk, M.D.*
[email protected] Contact: Lori Phone: (405) 230-9270 Fax: (405) 522-9474
1110 N Lee Oklahoma City, OK73103-2612
hands, shoulders, elbows, knees, wrists, forearm Excl. Body Parts/Svcs: neck, back, hips, feet American Board of Orthopedic Surgery TR
* Physician has multiple specialties.
Oklahoma Ctiy, Edmond
Date: 01/19/2017 Time: 08:45
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Page: 44
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
Orthopedic Surgery
Timothy Michael Geib, M.D.
13401 N Western Ave, Ste. 301 Oklahoma City, OK73114
knees, shoulders, elbows, hips, hands, arms
[email protected] Contact: Brooke Phone: (405) 517-3719 Fax: ( )
City of Exam
Edmond, OKC
Excl. Body Parts/Svcs: feet, back
-
American Board of Orthopedic Surgery TR Orthopedic Surgery
Robert A. German, M.D.
1110 N Lee Oklahoma City, OK73103-2612
[email protected] Contact: Lori Phone: (405) 230-9270 Fax: (405) 230-9474
knees, shoulders, elbows, ankles, arms, legs
Oklahoma City, Norman
Excl. Body Parts/Svcs: spine, neck American Board of Orthopedic Surgery TR
Orthopedic Surgery
Greg Halko, M.D.*
[email protected] Contact: central scheduling Phone: (405) 947-0911 Fax: (405) 942-5043
3301 NW 50 Oklahoma City, OK73112
hands, upper extremities Excl. Body Parts/Svcs: spine, (neck, back) and lower extremities American Board of Orthopedic Surgery T R MITF
* Physician has multiple specialties.
Oklahoma City
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 45
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
Orthopedic Surgery
Kevin Wayne Hargrove, M.D.
101 S Saints Blvd Ste 101 Edmond, OK73034
Orthopaedic Surgery; Sports Medicince-Shoulders and knees
[email protected] Contact: Work Comp Cordinator Phone: (405) 513-8326 Fax: (405) 513-7739
City of Exam
Edmond
Excl. Body Parts/Svcs: Surgical Spine Cases American Board of Orthopedic Surgery T MITF
Orthopedic Surgery
Bryan Hawkins, M.D.*
6585 S Yale Ave Ste 200 Tulsa, OK74136
[email protected] Contact: CSOS Phone: (918) 481-2767 Fax: (918) 481-7611
ankles, knees, feet, hip
Tulsa
Excl. Body Parts/Svcs: neck, spine, wrists, hands, elbows American Board of Orthopedic Surgery T R MITF
Orthopedic Surgery
Randall L. Hendricks, M.D.
[email protected] Contact: Allison Phone: (918) 481-2767 Fax: (918) 481-7611
6585 S Yale Ste 200 Tulsa, OK74136
neck, spine Excl. Body Parts/Svcs: shoulders, elbows, hips, knees hands, wrists, ankle American Board of Orthopedic Surgery T R MITF
* Physician has multiple specialties.
Tulsa
Date: 01/19/2017 Time: 08:45
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Page: 46
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
City of Exam
Orthopedic Surgery
David R. Hicks, M.D.
6585 S Yale Ave Ste 200 Tulsa, OK74136
neck and spine
Tulsa
[email protected] Contact: Central States Orthopedics Phone: (918) 481-2767 Fax: (918) 481-7611
Excl. Body Parts/Svcs: hands, wrists, elbows, shoulders, knees, hips, ankles American Board of Orthopedic Surgery T R MITF
Orthopedic Surgery
Robert Frazer Hines, M.D.
9800 Broadway Extension Suite 201 Oklahoma City, OK73114
[email protected] Contact: Naci Phone: (405) 348-6004 Fax: (405) 715-8853
shoulders, knees
Oklahoma City
Excl. Body Parts/Svcs: Neck, back, foot and ankle, elbow, hip American Board of Orthopedic Surgery T
Orthopedic Surgery
Gregory R. Holt, M.D.
[email protected] Contact: Rae Cheatham Phone: ( ) Fax: (918) 582-6060
1809 E 13 St Ste 100 Tulsa, OK74104
hips, knees, shoulders Excl. Body Parts/Svcs: Back, Neck American Board of Orthopedic Surgery T R MITF
* Physician has multiple specialties.
Tulsa
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 47
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
City of Exam
Orthopedic Surgery
Thomas C. Howard, M.D.*
1110 N Lee Oklahoma City, OK73103-2612
hands, shoulders, knees, hips and feet
Oklahoma City, Norman
[email protected] Contact: Lori Phone: (405) 230-9270 Fax: (405) 230-9424
Excl. Body Parts/Svcs: spine, (neck,back) American Board of Orthopedic Surgery TR
Orthopedic Surgery
John B. Hughes, D.O.
2149 SW 59 St Ste 102 Oklahoma City, OK73119
[email protected] Contact: Tammy Phone: (405) 682-5351 Fax: (405) 685-5563
all
Oklahoma City
Excl. Body Parts/Svcs: none American Board of Orthopedic Surgery T R MITF
Orthopedic Surgery
Christopher Shane Hume, D.O.
[email protected] Contact: scheduler Phone: (405) 427-3705 Fax: ( )
10001 S. Western Ave Suite 202 Oklahoma City, OK73139
spine (neck & back)
Oklahoma City
Excl. Body Parts/Svcs: all except speciality Board Eligible T
* Physician has multiple specialties.
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 48
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
City of Exam
Orthopedic Surgery
Antoine I. Jabbour, M.D.
4802 S 109 E Ave Tulsa, OK74146
knees, shoulders
Tulsa
[email protected] Contact: Latoya Phone: (918) 392-1400 Fax: (918) 392-1401
Excl. Body Parts/Svcs: spine, hands American Board of Orthopedic Surgery T
Orthopedic Surgery
Paul Jacob, D.O.
9800 Broadway Extension Suite 201 Oklahoma City, OK73114
[email protected] Contact: Joann Ellis Phone: (405) 424-5426 Fax: (405) 424-5416
adult reconstruction total joint replacement
Oklahoma City
Excl. Body Parts/Svcs: uper extremity injuries Certification Unknown T MITF
Orthopedic Surgery
Thomas P. Janssen, M.D.
[email protected] Contact: Lori Phone: (405) 230-9270 Fax: (405) 230-9474
1110 N Lee Oklahoma City, OK73103-2612
knees, hips, shoulders, feet, hands Excl. Body Parts/Svcs: neck,back American Board of Family Medicine & Orthopaedic Surgery TR
* Physician has multiple specialties.
Oklahoma City
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 49
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
City of Exam
Orthopedic Surgery
J. Calvin Johnson, M.D.
9800 Broadway Extension Suite 203 Oklahoma City, OK73114
knees, shoulders
Oklahoma City
[email protected] Contact: Scheduler Phone: (405) 419-5412 Fax: (405) 419-5468
Excl. Body Parts/Svcs: back,hands,ankles American Board of Orthopedic Surgery T
Orthopedic Surgery
Wayne A. Johnson, M.D.
8212 NW Stonebridge Ct Lawton, OK73506
[email protected] Contact: Cassandra Phone: (580) 536-2265 Fax: (580) 536-7805
shoulder, knee, hand/wrist, foot/ankle
Lawton
Excl. Body Parts/Svcs: back American Board of Orthopedic Surgery T R MITF
Orthopedic Surgery
Daniel J. Jones, M.D.
[email protected] Contact: Alice Mata Phone: (405) 632-4468 Fax: (405) 632-4317
8100 S Walker Ave Bldg A Oklahoma City, OK73139
knee, shoulder, foot, ankle, legs, arms, elbows Excl. Body Parts/Svcs: spine and neck American Board of Orthopaedic Surgery T R MITF
* Physician has multiple specialties.
Oklahoma City
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 50
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
City of Exam
Orthopedic Surgery
Michael E. Kiehn, M.D.
3301 NW 50 St Oklahoma City, OK73112
knees, shoulders
Oklahoma City
[email protected] Contact: Jaye Dee Watts Phone: (405) 947-0911 Fax: (405) 942-5043
Excl. Body Parts/Svcs: spine (neck, back) American Board of Orthopaedic Surgery T R MITF
Orthopedic Surgery
Richard Kirkpatrick, M.D.*
3400 W Tecumseh Rd Ste 101 Norman, OK73072
[email protected] Contact: Brooke Phone: (405) 517-3719 Fax: (405) 360-6769
knees, shoulders, elbows, hands, hips, ankles, arms
Oklahoma City, Norman
Excl. Body Parts/Svcs: spine American Board of Orthopaedic Surgery TR
Orthopedic Surgery
Zakary A. Knutson, M.D.
[email protected] Contact: Brooke Phone: (405) 517-3719 Fax: ( )
3400 W Tecumseh Ste 101 Norman, OK73072
hips, knees, shoulders, elbows Excl. Body Parts/Svcs: foot, ankle, neck and back
Certification Unknown TR
* Physician has multiple specialties.
Norman, Edmond
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 51
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
Orthopedic Surgery
Mark F. Kowalski, M.D.
4140 W Memorial Rd Ste 308 Oklahoma City, OK73120
all orthopaedic surgery except spine, hips, and neck Excl. Body Parts/Svcs: hips, back, neck
Contact: Kayla, Shawna, Cathy Phone: (405) 749-7031 Fax: (405) 749-7036
City of Exam
Oklahoma City
American Board of Orthopedic Surgery TR Orthopedic Surgery
Sarat Kunapuli, D.O.
Contact: Lori Phone: (918) 494-9300 Fax: ( )
6475 S Yale Suite 301 Tulsa, OK74136
Knees, Hips and Shoulders
Tulsa
Excl. Body Parts/Svcs: all except listed American Osteopathic Association TR
Orthopedic Surgery
E. Alexander L'Heureux, Jr., M.D.
Contact: Jennifer Phone: (405) 844-5222 Fax: (405) 744-2166
1405 NW 150 St Edmond, OK73013
cervical, thoracic and lumbar spine Excl. Body Parts/Svcs: all except spine American Board of Orthopedic Surgery & Spine Surgery T
* Physician has multiple specialties.
Edmond
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 52
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
City of Exam
Orthopedic Surgery
Ronald S. LaButti, D.O.*
6585 S Yale Ave Ste 200 Tulsa, OK74136
hips, knees, ankles, foot
Tulsa
[email protected] Contact: appt desk Phone: (918) 481-2767 Fax: (918) 481-7611
Excl. Body Parts/Svcs: hand, elbow, arms, shoulders American Osteopathic Aacademy of Orthopedics T R MITF
Orthopedic Surgery
Bradley J. Lawson, M.D.
[email protected] Contact: scheduling Phone: (918) 481-2767 Fax: ( )
6585 S Yale Ave Ste 200 Tulsa, OK74136
ankle, shoulder, hip, knee, foot, elbow, hand, wrist
Tulsa
Excl. Body Parts/Svcs: none
-
American Board of Orthopaedic Surgery T R MITF Orthopedic Surgery
Brian A. Levings, D.O.
[email protected] Contact: Alice Mata Phone: (405) 632-4468 Fax: (405) 632-4317
8100 S Walker Ave Bldg A Oklahoma City, OK73139
arms, legs, shoulders, knees, feet, ankles, elbows Excl. Body Parts/Svcs: back, neck American Osteopathic Board of Orthopaedic Surgery T R MITF
* Physician has multiple specialties.
Oklahoma City
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 53
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
City of Exam
Orthopedic Surgery
Alan G. Lewis, M.D.
6475 S Yale Ave Ste 301 Tulsa, OK74136-7824
feet, ankles, knees
Tulsa
[email protected] Contact: Damita Carter 918-481-7658 Phone: (918) 494-9300 Fax: (918) 494-9397
Excl. Body Parts/Svcs: spine, hips, hands, elbows, shoulders, rate only cases American Board of Orthopedic Surgery TR
Orthopedic Surgery
J. Patrick Livingston, M.D.
1211 N Shartel Suite 500 Oklahoma City, OK73103
Contact: Allison Phone: (405) 463-0407 Fax: (405) 463-0425
orthopedic surgery, neck, back, shoulders, hips, arms, legs, hands, feet
Oklahoma City
Excl. Body Parts/Svcs: head, brain, lungs, heart urogenital, gastrointestinal American Board of Orthopedic Surgery T R MITF
Orthopedic Surgery
Jay D. Lorton, M.D.
[email protected] Contact: Lori Phone: (918) 494-9300 Fax: (918) 494-9397
6475 S Yale Ave Ste 301 Tulsa, OK74136
knees, shoulders, elbows Excl. Body Parts/Svcs: spine, hands, hips, feet American Board of Orthopedic Surgery TR
* Physician has multiple specialties.
Tulsa
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 54
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
City of Exam
Orthopedic Surgery
Paul D. Maitino, D.O.
3110 SW 89 Street Ste 200D Oklahoma City, OK73159
hips, knees, shoulders
Oklahoma City
[email protected] Contact: Jessica Phone: (405) 680-5633 Fax: (405) 735-6435
Excl. Body Parts/Svcs: head Orthopedic Surgery T R MITF
Orthopedic Surgery
Bradley Margo, M.D.
1110 N Lee Oklahoma City, OK73103-2612
[email protected] Contact: Lori Phone: (405) 230-9270 Fax: (405) 230-9475
shoulders, knees
Oklahoma City
Excl. Body Parts/Svcs: backs, necks, hips, feet, hands American Board of Orthopaedic Surgery TR
Orthopedic Surgery
Robert Marsh, D.O.
Contact: Wendy Phone: (918) 494-9300 Fax: ( )
6475 S Yale Ave. Suite 301 Tulsa, OK74136
FOOT, ANKLE Excl. Body Parts/Svcs: all but foot and ankle
American Osteopathic Association TR
* Physician has multiple specialties.
Tulsa
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 55
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
Orthopedic Surgery
James C. Mayoza, M.D.
6122 E 61 St Tulsa, OK74136-2117
lumbar and cervical spine & extremities
City of Exam
Tulsa
Contact: Nicci or Morgie Phone: (918) 492-3133 Fax: (918) 493-2215 American Board of Orthopedic Surgery T R MITF Orthopedic Surgery
Yogesh Mittal, M.D.
1809 E 13 St Ste 100 Tulsa, OK74104
Contact: Nancy 918-925-3204 Phone: (918) 582-6800 Fax: (918) 301-4293
Orthopedic Surgeon-Total JointKnees-Hips Excl. Body Parts/Svcs: spine
Tulsa
American Board of Orthopaedic Surgery T Orthopedic Surgery
Mac E. Moore, M.D.
Contact: Belinda Phone: (405) 692-3737 Fax: (405) 692-3707
10001 S Western Ste 200 Oklahoma City, OK73139-2997
shoulders, elbows, knees Excl. Body Parts/Svcs: none American Board of Orthopaedic Surgery T R MITF
* Physician has multiple specialties.
Oklahoma City
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 56
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
City of Exam
Orthopedic Surgery
Jeffrey R. Morris, D.O.*
6585 S. Yale Ave Suite 200 Tulsa, OK74136
shoulder, hand, wrist, hip, knee, ankles & total joint replacements
Tulsa
[email protected] Contact: Reggie 918-583-7076 Phone: (918) 481-2767 Fax: (918) 583-7908
Excl. Body Parts/Svcs: neck, spine American Osteopathic Board of Orthopedfic Surgery T R MITF
Orthopedic Surgery
Mark Robert Moses, M.D.
825 E Robinson Norman, OK73071
[email protected] Contact: Gaylene Phone: (405) 364-7900 Fax: (405) 366-6214
hips, knees, shoulders,hands, wrists
Norman
Excl. Body Parts/Svcs: neck, back American Board of Orthopaedic Surgery TR
Orthopedic Surgery
Ryan L. Nelson, D.O
Contact: Joann Phone: (405) 330-8847 Fax: ( )
1616 S. Kelly Edmond, OK73013
-
shoulder, elbow, knee (trauma/fractures) hip, wrist, ankle
Edmond
Excl. Body Parts/Svcs: none Certification Unknown T R MITF
* Physician has multiple specialties.
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 57
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
City of Exam
Orthopedic Surgery
David E. Nonweiler, M.D.
6585 S Yale Ave Ste 200 Tulsa, OK74136
shoulders, knees
Tulsa
[email protected] Contact: Melissa Phone: (918) 481-2767 Fax: (918) 481-7611
Excl. Body Parts/Svcs: neck and spine American Board of Orthopedic Surgery T R MITF
Orthopedic Surgery
M. Sean O'Brien, D.O.*
Contact: Marilyn Phone: (405) 759-2663 Fax: ( )
3110 SW 89th St., Suite 200C Oklahoma City, OK73159
Hands and Shoulders
Oklahoma City
Excl. Body Parts/Svcs: back, neck, feet American Osteopathic Board of Orthopedic Surgery T
Orthopedic Surgery
James M. Odor, M.D. Contact: Valerie, Renee Phone: (405) 242-4345 Fax: (405) 242-4333
14100 Parkway Commons Dr Ste 200 Oklahoma City, OK73134
cervical, thoracic & lumbar spine (neck and back) Excl. Body Parts/Svcs: None American Board of Orthopedic Surgery T
* Physician has multiple specialties.
Oklahoma City
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 58
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
City of Exam
Orthopedic Surgery
L. Todd Olsen, D.O.
Olsen Orthopedics 3400 S Douglas Blvd Ste 302 Oklahoma City, OK73150
knees, shoulders
MWC
Contact: Wendy, Cheryl Phone: (405) 733-8000 Fax: (405) 733-7820
Excl. Body Parts/Svcs: backs American Osteopathic Board of Orthopedic Surgery T
Orthopedic Surgery
Victor R. Palomino, D.O.*
[email protected] Contact: Rae Phone: (918) 582-6800 Fax: ( )
1809 E 13 St Ste 100 Tulsa, OK74104
Orthopedics; Sports Medicine
Tulsa
Excl. Body Parts/Svcs: Back, Foot/ankle, hand American Osteopathic Board T
Orthopedic Surgery
Kris Parchuri, D.O. sostulsa.com Contact: Sarah Phone: (539) 664-4448 Fax: (539) 664-4288
9101 S Toledo Ave Ste B Tulsa, OK74137
spine
Tulsa
Excl. Body Parts/Svcs: hands, feet AOA T R MITF
* Physician has multiple specialties.
Date: 01/19/2017 Time: 08:45
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Page: 59
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
City of Exam
Orthopedic Surgery
Andrew Parkinson, M.D.
3301 NW 50 St Oklahoma City, OK73112
spine, (neck, back), lower extremities
Oklahoma City
[email protected] Contact: central scheduling Phone: (405) 947-0911 Fax: ( )
Excl. Body Parts/Svcs: all except spine & lower extremities
-
American Board of Orthopaedic Surgery T R MITF Orthopedic Surgery
Ghazi M. Rayan, M.D.*
3366 NW Expressway Ste 700 Oklahoma City, OK73112-4418
shoulder, elbow, wrist, hand
Oklahoma City
Excl. Body Parts/Svcs: back
Contact: Phone: (405) 945-4888 Fax: (405) 945-4887
American Board of Orthopedic Surgery/ Am Bd of Ortho Surg of Hand T R MITF Orthopedic Surgery
Vytautas M. Ringus, M.D.
[email protected] Contact: Monique Phone: (405) 364-7900 Fax: (405) 310-6866
825 E Robinson Norman, OK73071
foot and ankle
Norman
Excl. Body Parts/Svcs: none Certification Unknown T R MITF
* Physician has multiple specialties.
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 60
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
City of Exam
Orthopedic Surgery
R. Clio Robertson, M.D.*
6585 S Yale Ave Ste 200 Tulsa, OK74136
neck, spine, shoulder, elbows, wrists, hips, knees, ankles
Tulsa
[email protected] Contact: Phone: (918) 481-2767 Fax: (918) 481-7611 American Board of Orthopedic Surgery T R MITF Orthopedic Surgery
Richard A. Ruffin, M.D.*
3301 NW 50 Oklahoma City, OK73112-5691
hands, wrists, elbows, shoulders
Oklahoma City
Excl. Body Parts/Svcs: neck & back (spine), feet, knees
Contact: Central Scheduling Phone: (405) 947-0911 Fax: (405) 947-4263
American Board of Orthopedic Surgery, Hand Surgery T Orthopedic Surgery
Houshang Seradge, M.D.* Contact: Misti Phone: (405) 634-4263 Fax: ( )
1044 SW 44 Street Suite 518 Oklahoma City, OK73109
spine, foot, wrist, elbow, shoulder, hip, knee, ankle
American Board of Orthopedic Surgery T R MITF
* Physician has multiple specialties.
Oklahoma City
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 61
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
Orthopedic Surgery
Blake Shockley, M.D.
6585 S Yale Ave Suite 200 Tulsa, OK74136
shoulder, elbow, hip, knee and ankle
[email protected] Contact: Jennifer. Angie Phone: (918) 481-2767 Fax: ( )
City of Exam
Tulsa area
Excl. Body Parts/Svcs: spine, hand
-
American Board of Orthopedic Surgery T R MITF Orthopedic Surgery
James C. Slater, M.D.
4802 S 109 E Ave Tulsa, OK74146
adult reconstruction
Tulsa
Excl. Body Parts/Svcs: hands, feet,back, neck, (spine)
Contact: Latoya Phone: (918) 392-1437 Fax: (918) 392-1401
American Board of Orthopedic Surgery T Orthopedic Surgery
Glenn L. Smith, D.O.
[email protected] Contact: Linda Phone: (405) 682-4651 Fax: (405) 682-3391
2149 SW 59 Ste 101 Oklahoma City, OK73119
all orthopedic surgery
Oklahoma City
Excl. Body Parts/Svcs: Feet Orthopedic Surgery T
* Physician has multiple specialties.
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 62
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
Orthopedic Surgery
Sheryl C. Smith, M.D.
9800 Broadway Extension Suite 201 Oklahoma City, OK73114
foot, ankle
[email protected] Contact: Kim Phone: (405) 419-5610 Fax: (405) 419-5429
City of Exam
Oklahoma City
Excl. Body Parts/Svcs: all except foot & ankle Certification Unknown TR
Orthopedic Surgery
Cheng-Lun Soo, M.D.
1044 SW 44 Street Oklahoma City, OK73109
[email protected] Contact: Ernest Phone: (405) 631-4263 Fax: (405) 631-1767
spine, neck, lumbar, cervical
Oklahoma City
Excl. Body Parts/Svcs: all except neck and back American Board of Orthopedic Surgery TR
Orthopedic Surgery
Richard M. Stamile, M.D.
[email protected] Contact: Latoya Phone: (918) 392-1437 Fax: (918) 392-1401
4802 S 109 E Ave #100 Tulsa, OK74146
general orthopedics no surgery Excl. Body Parts/Svcs: back, neck, hands American Board of Orthopedic Surgery TR
* Physician has multiple specialties.
Tulsa
Date: 01/19/2017 Time: 08:45
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Page: 63
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
Orthopedic Surgery
Wesley Michael Stotler, D.O.
4802 S 109 E Ave Tulsa, OK74146
foot, ankle
[email protected] Contact: Denise Phone: (918) 392-1403 Fax: (918) 392-1401
City of Exam
Tulsa
Excl. Body Parts/Svcs: all except feet and ankles American Osteopathic Board of Orthopedic Surgery T
Orthopedic Surgery
Robert S. Unsell, M.D.
10001 S Western Ste 101 Oklahoma City, OK73139
[email protected] Contact: Darcy Phone: (405) 692-3700 Fax: (405) 923-3783
hands, wrist, elbows
Oklahoma City
Excl. Body Parts/Svcs: spine, lower extremities Certification Unknown T R MITF
Orthopedic Surgery
Mark Stephen Wilson, M.D.* Contact: TU-Sandra, OKC-Tayller Phone: (918) 488-8285 Fax: (405) 949-1801
5522 S Lewis Tulsa, OK74105
all orthopedics, continuing medical maintenance Excl. Body Parts/Svcs: None Certification Unknown T R MITF
* Physician has multiple specialties.
Tulsa, OKC
Date: 01/19/2017 Time: 08:45
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Page: 64
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
City of Exam
Orthopedic Surgery
David K. Wong, M.D.
6585 S Yale Ave Ste 200 Tulsa, OK74136
hands, wrists, elbows, shoulders
Tulsa
[email protected] Contact: Patti Phone: (918) 481-2767 Fax: (918) 481-7611
Excl. Body Parts/Svcs: neck, spine, knees, hips, ankles American Board of Orthopedic Surgery T R MITF
Orthopedic Surgery
Michael Wright, M.D.
3115 SW 89 Oklahoma City, OK73159
Spine (evaluat all body parts)
Oklahoma City
Excl. Body Parts/Svcs: None
Contact: Krista Phone: (405) 424-5630 Fax: (405) 692-1632
American Board of Spine Surgery TR Orthopedic Surgery
Gregory J. Zeiders, D.O.
[email protected] Contact: Lindsay Phone: (405) 509-7370 Fax: (405) 509-7373
1800 S. Renaissance Blvd, Suite 210 Edmond, OK73013
hands, wrists, elbows, shoulders, feet, ankles, knees, hips Excl. Body Parts/Svcs: spine American Osteopathic Board of Orthopedic Surgery TR
* Physician has multiple specialties.
Edmond, Oklahoma City, Shawnee
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 65
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
City of Exam
Orthopedics
Darnell E. Blackmon, M.D.*
1809 E 13 Ste 100 Tulsa, OK74104
Sports Medicine, Food and Ankle
Tulsa
Excl. Body Parts/Svcs: spine, hand
Contact: Rae Phone: (918) 582-6800 Fax: (918) 582-6060
American Board of Orthopaedic Surgery TR Orthopedics
Joel M. Davis, M.D.
3301 NW 50 Street Oklahoma City, OK73112
[email protected] Contact: central scheduling Phone: (405) 947-0911 Fax: (405) 947-1341
lower extremities, feet, ankles
OKC
Excl. Body Parts/Svcs: Spine (neck, back) Certification Unknown T R MITF
Orthopedics
William Bentley Edmonds, M.D.
[email protected] Contact: Lori Phone: (405) 230-9270 Fax: (405) 230-9424
1110 N Lee Oklahoma City, OK73103-2612
foot, ankle Excl. Body Parts/Svcs: all except foot and ankle American Board of Orthopaedic Surgery TR
* Physician has multiple specialties.
Oklahoma City, Edmond, Norman
Date: 01/19/2017 Time: 08:45
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Page: 66
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
City of Exam
Orthopedics
David Holden, M.D.
1110 N Lee Oklahoma City, OK73103-2612
knees & shoulders only
Oklahoma City, Norman
[email protected] Contact: Lori Phone: (405) 230-9270 Fax: ( )
Excl. Body Parts/Svcs: Spine, Neck, Hip, Ankles, Feet, Elbows
-
American Board of Orthopaedic Surgery & Sports Medicine T Orthopedics
Michael Brandon Johnson, M.D.
9800 Broadway Extension Suite 203 Oklahoma City, OK73114
all within specialty
OKC
Excl. Body Parts/Svcs: Spine
Contact: Debra Lewis Phone: (405) 424-5417 Fax: (405) 424-5418
Certification Unknown T Orthopedics
Faustino Kazenske, D.O.
Contact: Central Scheduling Phone: (405) 947-0911 Fax: ( )
3301 NW 50th Street Oklahoma City, OK73112
Lower extremities, hips, knees Excl. Body Parts/Svcs: Upper extremities and back
Certification Unknown T R MITF
* Physician has multiple specialties.
Oklahoma City
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 67
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
City of Exam
Orthopedics
Richard Kirkpatrick, M.D.*
3400 W Tecumseh Rd Ste 101 Norman, OK73072
knees, shoulders, elbows, hands, hips, ankles, arms
Oklahoma City, Norman
[email protected] Contact: Brooke Phone: (405) 517-3719 Fax: (405) 360-6769
Excl. Body Parts/Svcs: spine American Board of Orthopaedic Surgery TR
Orthopedics
John Wheeler, M.D.
Contact: Kim Phone: (405) 424-5630 Fax: ( )
3115 SW 89 Oklahoma City, OK73159
all within specialty
Oklahoma City
Excl. Body Parts/Svcs: none American board of Orthopedic Surgery TR
Otolaryngology
R. Stanley Baker, M.D.
[email protected] Contact: Dawn Phone: (405) 946-5563 Fax: ( )
3400 NW 56 St Oklahoma City, OK73112
ears Excl. Body Parts/Svcs: all other than ears
American Board of Otolaryngology TR
* Physician has multiple specialties.
Oklahoma City
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 68
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
Otolaryngology
Alen Munson Fuller, M.D.
1725 E 19 St Ste 100 Tulsa, OK74104
ears (cumulative hearing loss)
[email protected] Contact: Betsi Phone: (918) 742-7376 Fax: (918) 743-2117
City of Exam
Tulsa
Excl. Body Parts/Svcs: surgical cases American Board of Otolaryngology TR
Otolaryngology
John R. Houck, M.D.
920 Stanton L Young WP 1290 Oklahoma City, OK73104
[email protected] Contact: Tiffney tiffaney-cardwell@ouhs Phone: (405) 271-1368 Fax: (405) 271-3248
ear, nose, throat
OKC
Excl. Body Parts/Svcs: complaints of dizziness or hearing loss American Board of Otolaryngology T
Otolaryngology
Paul David Hunter, M.D.*
[email protected] Contact: Dianne Hunter Phone: (405) 272-6027 Fax: (405) 272-8315
535 NW 9th Street #300 Oklahoma City, OK73102
Ears, nose, throat and facial trauma Excl. Body Parts/Svcs: all others but listed AM Board of Otolaryngology T
* Physician has multiple specialties.
Oklahoma City
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 69
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
Otology
Mark Wood, M.D.
3400 NW 56 St Oklahoma City, OK73112
ears, hearing, including dizziness
[email protected] Contact: Valoree Phone: (405) 946-5563 Fax: (405) 945-7185
City of Exam
Oklahoma City
Excl. Body Parts/Svcs: anything other than ears American Board of Otolaryngology TR
Physical Medicine and Rehabilitation
Donald E. Adams, M.D.
1616 S Kelly Edmond, OK73013-3651
[email protected] Contact: Joann Phone: (405) 330-0032 Fax: (405) 330-0092
pain management
Edmond
Excl. Body Parts/Svcs: feet, ankles American Board of Medicine & Rehabilitation & Pain Medicine TR
Physical Medicine and Rehabilitation
Archana Barve, M.D.
[email protected] Contact: Stacey Phone: (405) 949-6481 Fax: (405) 795-5909
3613 NW 56 STREET STE 140 Oklahoma City, OK73112
sports medicine, physical medicine & rehabilitation Excl. Body Parts/Svcs: spinal cord injury with paraplegia, quadriplegia American Board of Physical Medicine/Rehabilitation T
* Physician has multiple specialties.
Oklahoma City
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 70
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
City of Exam
Physical Medicine and Rehabilitation
Albert J. Bisson, M.D.
4120 W Memorial Rd Ste 118 Oklahoma City, OK73120
physiatry - head, spine, upper and lower extremities, nerve and joint problems
Oklahoma City
[email protected] Contact: Cecylia Phone: (405) 748-4700 Fax: (405) 748-5638
Excl. Body Parts/Svcs: narcotic mngmt, rsd American Board of Physical Medicine/Rehabilitation TR
Physical Medicine and Rehabilitation
Michael S. Brown, M.D.
4120 W Memorial Rd Ste 118 Oklahoma City, OK73120
[email protected] Contact: Cecylia Phone: (405) 748-4700 Fax: (405) 748-5638
physiatry - head, neck, spine upper and lower extremities, nerve and joint problems
Oklahoma City
Excl. Body Parts/Svcs: narcotic pain management, RSD American Academy of Physical Medicine/Rehab TR
Physical Medicine and Rehabilitation
A. E. Moorad, M.D.*
4221 S Western Ste 3010 Oklahoma City, OK73109
all PM & R, pain managment
Contact: Marilyn Phone: (405) 636-7450 Fax: (405) 631-2296 American Board of Internal Medicine T R MITF
* Physician has multiple specialties.
Oklahoma City
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 71
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
Physical Medicine and Rehabilitation
Darryl Dermot Robinson, M.D.
3110 SW 89 Ste 102 Oklahoma City, OK73159
all within speciality
[email protected] Contact: Lindsey Phone: (405) 703-4950 Fax: (405) 703-4955
City of Exam
Oklahoma City
Excl. Body Parts/Svcs: None American Board of Physical Medicine and Rehab-Pain Management T R MITF
Physical Medicine and Rehabilitation
Kathleen M. Sisler, M.D.
6585 S Yale Ave Ste 200 Tulsa, OK74136
[email protected] Contact: Allison Phone: (918) 481-2767 Fax: (918) 481-7669
elbows, hands, knees, hips, neck, spine, feet, ankles, wrists, shoulders (Physiatry)
Tulsa
Excl. Body Parts/Svcs: none American Board of Physical Medicine/Rehabilitation T R MITF
Physical Medicine and Rehabilitation
Michael Shawn Smith, M.D.
5100 N Brookline Ste 500 Oklahoma City, OK73112
PM&R, spine, spinal cord and brain injuries
[email protected] Contact: Alecia Phone: (405) 605-8780 Fax: (405) 605-8782 American Board of Physical Medicine/Rehabilitation T R MITF
* Physician has multiple specialties.
Oklahoma City
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 72
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
City of Exam
Physical Medicine and Rehabilitation
Jonathan B. Stone, D.O.
700 NW 7 Street Ste 115 Oklahoma City, OK73102
all within speciality chronic medication management, continuing medical maintenance
Oklahoma City
[email protected] Contact: Sarah Phone: (405) 601-5899 Fax: (405) 601-5903
American Board of Physical Medicine and Rehabilitation T Physical Medicine and Rehabilitation
D. Brent Tipton, M.D.
5100 N Brookline Ste 530 Oklahoma City, OK73112
[email protected] Contact: Linda Phone: (405) 604-6652 Fax: (405) 604-6653
muscles and nerves
Oklahoma City
Excl. Body Parts/Svcs: heart, lungs, GI, Renal, medical maintenance, pain management American Board of Physical Medicine/Rehabilitation/Electrodiag nos TR
Plastic Surgery
Mehdi N. Adham, M.D.* Contact: Alice Phone: (405) 632-4468 Fax: (405) 632-4317
8100 S Walker Ave Bldg A Oklahoma City, OK73139
plastic & reconstructive surgery of hands and wrists Excl. Body Parts/Svcs: all except plastic surgery of hands/wrists American Board of Plastic Surgery & Am Bd Plastic Surg of Hand T R MITF
* Physician has multiple specialties.
Oklahoma City
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 73
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
Plastic Surgery
Paul David Hunter, M.D.*
535 NW 9th Street #300 Oklahoma City, OK73102
Ears, nose, throat and facial trauma
[email protected] Contact: Dianne Hunter Phone: (405) 272-6027 Fax: (405) 272-8315
City of Exam
Oklahoma City
Excl. Body Parts/Svcs: all others but listed AM Board of Otolaryngology T
Podiatry
Armando A. Carro, D.P.M.
600 W 15 St Edmond, OK73013
[email protected] Contact: Phone: (405) 348-4141 Fax: (405) 340-0686
foot, ankle
Edmond and Shawnee
Excl. Body Parts/Svcs: None Certification Unknown T
Podiatry
David C. Cavallaro, D.P.M.
[email protected] Contact: Brandie Phone: (405) 631-4263 Fax: (405) 616-2670
1044 SW 44 floor 6 Oklahoma City, OK73109
feet, ankles and related structures Excl. Body Parts/Svcs: Upper Body American Board of Podiatric Surgery T
* Physician has multiple specialties.
Oklahoma City
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 74
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
Podiatry
Timothy Siegfried, D.P.M.
10229 E 96 Street North Ste 100 Owasso, OK74055
foot, ankle
[email protected] Contact: Melissa Phone: (918) 494-2902 Fax: (918) 272-8922
City of Exam
Owasso
Excl. Body Parts/Svcs: none within specialty American Board of Podiatric Surgery T R MITF
Podiatry
William K. Smith, D.P.M.
1627 N Kickapoo Shawnee, OK74804
Foot and Ankle
Shawnee, Oklahoma City
[email protected] Contact: Crissy,275-8234 Lori4059437797 Phone: (405) 275-8234 Fax: (405) 275-7298 American Board of Podiatric Surgery T R MITF Podiatry
Richard J Traczyk, II, D.P.M.
4205 McAuley Blvd Ste 465 Oklahoma City, OK73120
[email protected] Contact: Lanae Phone: (405) 755-7600 Fax: (405) 755-7680
foot, ankle
Oklahoma City
Excl. Body Parts/Svcs: anything above the ankle and ankle surgery Certification Unknown T R MITF
Psychiatry
Dominic Losacco, M.D.
6565 S Yale Ave Ste 706 Tulsa, OK74136-8308
all within psychiatric specialty
Contact: Mary, Mitzie Phone: (918) 491-5767 Fax: (918) 491-5771 American Board of Psychiatry and Neurology * Physician has multiple specialties.
Tulsa
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 75
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
City of Exam
Psychiatry
Siavash Nael, M.D.
4720 S Western Ave Oklahoma City, OK73109-3834
psychiatry
Oklahoma City
[email protected] Contact: any staff member Phone: (405) 634-5529 Fax: (405) 634-1673 American Board of Pyschiatry and Neurology T Psychology - Clinical
Russell L. Adams, Ph.D.*
PO Box 26901 WP3440 Oklahoma City, OK73126
brain, pain management, psychological overlay
Oklahoma City
Contact: Gary Phone: (405) 271-8001 Fax: (405) 271-8802 American Board of Professional Psychology/Clinical Neuropsych TR Psychology - Clinical
Faust Bianco, Jr., Ph.D.*
Contact: Suzan Phone: (918) 746-0794 Fax: (918) 746-0717
7146 S Braden Ave Ste 500 Tulsa, OK74136
Rehabilitation (nervous system, whole body) Trauma Related Disorders (pain stress, depression, brain) Excl. Body Parts/Svcs: none Certification Unknown T R MITF
* Physician has multiple specialties.
Tulsa
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 76
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
Psychology - Clinical
Douglas O. Brady, Ph.D.*
1401 SW Park Ridge Blvd Ste D Lawton, OK73505
Brain; Back (Spine); Chronic pain issues multiple sites
City of Exam
Lawton
[email protected] Contact: D'Ann Smith Phone: (580) 355-7474 Fax: (580) 355-6765 American Board of Professional Disability T R MITF Psychology - Clinical
R. Keith Green, Ph.D.
5929 N May Ave Ste 508 Oklahoma City, OK73112
[email protected] Contact: Virginia Green Phone: (405) 842-6446 Fax: (405) 842-5644
psychological evaluations and therapy
Oklahoma City
Excl. Body Parts/Svcs: None Certification Unknown T
Psychology - Clinical
David E. Johnsen, Ph.D.
[email protected] Contact: Lea or Angela Phone: (405) 755-8576 Fax: (405) 755-6026
2601 NW Expway Ste 410 W Oklahoma City, OK73112
psychological overlay, chronic pain, neuropsychology Excl. Body Parts/Svcs: None Certification Unknown TR
* Physician has multiple specialties.
Oklahoma City
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 77
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
City of Exam
Psychology - Clinical
Edgar J. Kranau, Ph.D.*
PO Box 14082 Tulsa, OK74159-4082
psychological overlay, pain management
Tulsa
[email protected] Contact: self Phone: (918) 712-9020 Fax: (918) 712-9021
Excl. Body Parts/Svcs: None Certification Unknown T R MITF
Psychology - Clinical
Doris Wise, Ph.D.
[email protected] Contact: Debbie Phone: (405) 286-6000 Fax: ( )
P.O. Box 60847 Oklahoma City, OK73146
psychological: mood, coping, adjustment, rehab
Oklahoma City
Excl. Body Parts/Svcs: none
-
Certification Unknown T Psychology
Michael R. Basso, Ph.D.*
[email protected] Contact: Dr. Basso Phone: (918) 631-3151 Fax: (918) 631-2833
Univ of Tulsa Dept of Psychology 800 S Tucker Drive Tulsa, OK74104
head/brain - diatnostic testing, psychological overlay Excl. Body Parts/Svcs: None ABPP - Clinical Neuropsychology R MITF
* Physician has multiple specialties.
Tulsa
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 78
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
Psychology
Stephen D. Carella, Ph.D.
3035 NW 63 Ste 103 Oklahoma City, OK73116
psychological overlay
City of Exam
Oklahoma City
[email protected] Contact: Sue Phone: (405) 840-4212 Fax: (405) 840-4258 Certification Unknown T R MITF Psychology
Edgar J. Kranau, Ph.D.*
PO Box 14082 Tulsa, OK74159-4082
[email protected] Contact: self Phone: (918) 712-9020 Fax: (918) 712-9021
psychological overlay, pain management
Tulsa
Excl. Body Parts/Svcs: None Certification Unknown T R MITF
Pulmonary Diseases
Dennis M. Parker, M.D.
Contact: Lisa Burgess 405-947-3345 Phone: (405) 917-5439 Fax: (405) 494-0849
3366 NW Expressway Ste 660 Oklahoma City, OK73112
pulmonary (lungs) Excl. Body Parts/Svcs: all except respiratory disease American Board of Internal Medicine, Am Bd - Pulmonary Disease T R MITF
* Physician has multiple specialties.
Oklahoma City
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 79
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
City of Exam
Sports Medicine
Gary B. Anderson, M.D.*
3301 NW 50 St Oklahoma City, OK73112
knees, shoulders, hips, elbows
Oklahoma City
[email protected] Contact: Scheduling Phone: (405) 947-0911 Fax: (405) 947-0775
Excl. Body Parts/Svcs: spine (back, neck), hands American Board of Orthopedic Surgery T R MITF
Sports Medicine
Clint Justin Basener, D.O.*
9709 E 79 Street S Tulsa, OK74133-4566
[email protected] Contact: Pam Phone: (918) 994-4068 Fax: (918) 994-4095
all within specialty
Tulsa
Excl. Body Parts/Svcs: All except brain, neck, spine Certification Unknown TR
Sports Medicine
Darnell E. Blackmon, M.D.*
Contact: Rae Phone: (918) 582-6800 Fax: (918) 582-6060
1809 E 13 Ste 100 Tulsa, OK74104
Sports Medicine, Food and Ankle Excl. Body Parts/Svcs: spine, hand American Board of Orthopaedic Surgery TR
* Physician has multiple specialties.
Tulsa
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 80
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
City of Exam
Sports Medicine
Bradford Boone, M.D.*
6475 S Yale Ave Ste 301 Tulsa, OK74136-7824
knees, shoulders, elbows
Tulsa
[email protected] Contact: Wendy Phone: (918) 494-9300 Fax: (918) 494-9397
Excl. Body Parts/Svcs: spine, hips, feet, ankles, hands & rate only cases American Board of Orthopedic Surgery/Sports Medicine TR
Sports Medicine
James D. Cash, M.D.*
6585 S Yale Ave Ste 200 Tulsa, OK74136
[email protected] Contact: Phone: (918) 481-2767 Fax: (918) 481-7611
knees, shoulders
Tulsa
Excl. Body Parts/Svcs: none American Board of Orthopedic Surgery T R MITF
Sports Medicine
Jeff A. Fox, M.D.*
Contact: appt desk Phone: (918) 481-7658 Fax: (918) 481-7611
6585 S Yale Ave Ste 200 Tulsa, OK74136
knees, ankles, elbow, shoulders Excl. Body Parts/Svcs: hand, spine American Board of Orthopedic Surgery T R MITF
* Physician has multiple specialties.
Tulsa
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 81
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
City of Exam
Sports Medicine
Troy A. Glaser, D.O.
6585 S Yale Ave Ste 200 Tulsa, OK74136
spine, knees, ankles, shoulders & foot
Tulsa
[email protected] Contact: Appt Desk Phone: (918) 481-7658 Fax: (918) 481-7611
Excl. Body Parts/Svcs: tailbone American Board of Family Medicine T R MITF
Sports Medicine
Bryan Hawkins, M.D.*
6585 S Yale Ave Ste 200 Tulsa, OK74136
[email protected] Contact: CSOS Phone: (918) 481-2767 Fax: (918) 481-7611
ankles, knees, feet, hip
Tulsa
Excl. Body Parts/Svcs: neck, spine, wrists, hands, elbows American Board of Orthopedic Surgery T R MITF
Sports Medicine
Ronald S. LaButti, D.O.*
[email protected] Contact: appt desk Phone: (918) 481-2767 Fax: (918) 481-7611
6585 S Yale Ave Ste 200 Tulsa, OK74136
hips, knees, ankles, foot Excl. Body Parts/Svcs: hand, elbow, arms, shoulders American Osteopathic Aacademy of Orthopedics T R MITF
* Physician has multiple specialties.
Tulsa
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 82
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
City of Exam
Sports Medicine
Jason M. Leinen, M.D.*
3115 SW 89 Street Oklahoma City, OK73159
all family & sports medicine, pain management (evaluate all body parts)
Oklahoma City
[email protected] Contact: Amy Phone: (405) 600-1411 Fax: (405) 600-1531
Excl. Body Parts/Svcs: none American Board of Family Medicine T
Sports Medicine
Jeffrey R. Morris, D.O.*
6585 S. Yale Ave Suite 200 Tulsa, OK74136
[email protected] Contact: Reggie 918-583-7076 Phone: (918) 481-2767 Fax: (918) 583-7908
shoulder, hand, wrist, hip, knee, ankles & total joint replacements
Tulsa
Excl. Body Parts/Svcs: neck, spine American Osteopathic Board of Orthopedfic Surgery T R MITF
Sports Medicine
Victor R. Palomino, D.O.*
[email protected] Contact: Rae Phone: (918) 582-6800 Fax: ( )
1809 E 13 St Ste 100 Tulsa, OK74104
Orthopedics; Sports Medicine Excl. Body Parts/Svcs: Back, Foot/ankle, hand
American Osteopathic Board T
* Physician has multiple specialties.
Tulsa
Date: 01/19/2017 Time: 08:45
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMS LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESP (Alphabetical by Specialty) As of January 1, 2017
Page: 83
Specialty
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
City of Exam
Sports Medicine
R. Clio Robertson, M.D.*
6585 S Yale Ave Ste 200 Tulsa, OK74136
neck, spine, shoulder, elbows, wrists, hips, knees, ankles
Tulsa
[email protected] Contact: Phone: (918) 481-2767 Fax: (918) 481-7611 American Board of Orthopedic Surgery T R MITF
* Physician has multiple specialties.