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OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 1
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Anesthesiology C. Scott Anthony, D.O. 6802 S Olympia Ave Ste 100 pain management - all body parts TulsaTulsa, OK74132-1823
[email protected] (credentialing) Excl. Body Parts/Svcs:Contact: NonePhone: (918) 447-9300 Fax: (918) 447-9308
American Board of AnesthesiologyT
Anesthesiology Blake D Christensen, D.O. PO Box 514 Spine Oklahoma CityNorman, OK73070-0514
[email protected] Excl. Body Parts/Svcs:Contact: Marleen Abdomen, Gynecology/UrologyPhone: (405) 751-0011 Fax: (405) 751-7246
American Board of Anesthesiology-Anesthesiology & Pain Medicine
T R MITF
Anesthesiology Gerald R. Hale, D.O. 2448 E 81 Ste 363 pain management TulsaTulsa, OK74137
[email protected] Excl. Body Parts/Svcs:Contact: Kara all except pain management casesPhone: (918) 477-5942 Fax: ( ) -
American Osteopathic Board ofAnesthesiology & Pain Management
T
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 2
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Anesthesiology Alina Justiz, Anesthesiology 4117 NW 122nd Street, Suite 100 NormanOklahoma City, OK73120
[email protected]: Anna TackPhone: (405) 463-3380 Fax: ( ) -
American Board of AnesthesologyT
Anesthesiology Rafael Justiz, Anesthesiology 4117 NW 122nd St., Suite C OKLAHOMACITY/NORMANOklahoma City, OK73120
[email protected]: Anna TackPhone: (405) 463-3380 Fax: ( ) -
American Board of Anesthesiologyw/pain managment
T R MITF
Anesthesiology Jayen H. Patel, M.D. 2811 E 15 Street Ste 102 pain management, neck, back, Tulsaextremities, nervous system,Tulsa, OK 7410-4headache, joints, [email protected]
Contact: appt deskExcl. Body Parts/Svcs:Phone: (918) 935-3240 Fax: (918) 935-3241PTSD, psychological trauma
American Board of AnesthesiologyT
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 3
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Anesthesiology Terrell R. Phillips, D.O. 401 SW 80 Street Bld D Ste 200 Pain Management Oklahoma CityOklahoma City, OK73139
Excl. Body Parts/Svcs:Contact: none within specialtyPhone: (405) 601-4227 Fax: (405) 601-4237
American Osteopathic Board ofAnesthesiology
T R MITF
Anesthesiology Brian Torgerson, M.D. 3336 E 32nd St #220 pain management TulsaTulsa, OK74135
[email protected]: Erin Al-HammamiPhone: (918) 255-7246 Fax: (918) 255-7000
Anesthesiology and Pain ManagementT
Anesthesiology Adam J. Wallace, M.D. 3336 E 32nd St #220 pain management TulsaTulsa, OK74135
[email protected] Excl. Body Parts/Svcs:Contact: Danielle, Bre , & Christy nonePhone: (918) 255-7246 Fax: (918) 255-7000
Certification UnknownT
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 4
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Anesthesiology Traci L. White, M.D. 6802 S Olympia Avenue Ste 100 Pain Management Only TulsaTulsa, OK74132
Contact: Danielle PiercePhone: (918) 513-3225 Fax: (918) 447-9308
American Board ofAnesthesiology/Pain Medicine
T
Chiropractic Seyoung Kim, D.C. 3435 NW 50th St. spine (neck, back) Oklahoma CityOklahoma City, OK73112
[email protected] Excl. Body Parts/Svcs:Contact: Kristen NonePhone: (405) 942-4040 Fax: (405) 773-4267
Certification UnknownT R
Chiropractic James Daniel Post, D.C. 4141 NW Expressway Ste 180 all chiropractics-spine Oklahoma CityOklahoma City, OK73116
[email protected]: CathyPhone: (405) 840-8900 Fax: (405) 840-8990
Certification UnknownT
Chiropractic Corey Stubbs, D.C. 9709 E 79th Street TulsaTulsa, OK74133
[email protected]: Traci LawleyPhone: (918) 994-4061 Fax: ( ) -
Certification UnknownT R
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 5
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Dentistry Bryan Chrz, D.D.S. 505 N 14 St all dental PerryPerry, OK73077
[email protected]: Shelley WileyPhone: (580) 336-2255 Fax: (580) 236-0362
American Board of ForensicOdonyology
T R MITF
Dentistry Steven W. Hogg, D.D.S. 423 W Washington St mouth, teeth, jaw Broken ArrowBroken Arrow, OK74012
[email protected] Excl. Body Parts/Svcs:Contact: Dr. Hogg NonePhone: (918) 645-3924 Fax: (918) 362-9997
Certification UnknownT R MITF
Family Medicine Jeffrey Cunningham, M.D.* 2408 E 81st Street, Suite 290 Head/Concussion TulsaTulsa, OK74137
Contact: MichellePhone: (918) 855-1255 Fax: ( ) -
American Board Family Medicine /Sports Medicine
T R MITF
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 6
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Family Medicine John Ellis, MD 5100 N Brookline Ave #465 Occupational & Legal Medicine, OKCEntire BodyOklahoma City, OK73112
[email protected]. Body Parts/Svcs:Contact: KellyeyesPhone: (405) 917-5336 Fax: ( ) -
American Board of Family MedicineT R MITF
Family Medicine Jason M. Leinen, M.D.* 3110 SW 89th Suite 102 all family & sports medicine, pain Oklahoma Citymanagement (evaluate all bodyOklahoma City, OK73159parts)[email protected]
Contact: SchedulerExcl. Body Parts/Svcs:Phone: (405) 703-3611 Fax: (405) 703-3711none
American Board of Family MedicineT
Family Medicine Michael L. Winzenread, M.D. 105 S Bryant Ste 310 all EdmondEdmond, OK73034
[email protected] Excl. Body Parts/Svcs:Contact: Kari Hill NonePhone: (405) 757-5211 Fax: ( ) -
American Board of Family Practice R MITF
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 7
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Family Practice Lance E. Rosson, D.O. 1211 N Shartel Ste 1104 all Oklahoma CityOklahoma City, OK73103
NONE Excl. Body Parts/Svcs:Contact: Sharon NonePhone: (405) 236-1900 Fax: (405) 236-0362
American Board of Family PhysiciansT R MITF
Hand Surgery Mehdi N. Adham, M.D.* 8100 S Walker Ave Bldg A plastic & reconstructive surgery of Oklahoma Cityhands and wristsOklahoma City, OK73139
[email protected]. Body Parts/Svcs:Contact: Alice Mata or Becky Tokarall except plastic surgery ofPhone: (405) 632-4468 Fax: (405) 632-4317hands/wrists
American Board of Plastic Surgery &Am Bd Plastic Surg of Hand
T R MITF
Hand Surgery Carolyn Berg, MD 2408 E 81st Street, Suite 290 Hand, Wrist, Elbow and Forearm TulsaTulsa, OK74137
[email protected] Excl. Body Parts/Svcs:Contact: Susan Spine, Knee, Ankles, Neck, Shoulder
ahd HumerusPhone: (918) 855-1255 Fax: (918) 494-9397
American Board of SurgeryT R
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 8
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Hand Surgery James F. Bischoff, M.D.* 2448 East 81st Street Suite1200 Hands TulsaTulsa, OK74137
Excl. Body Parts/Svcs:Contact: Naomi Traczyk spine, elbows, shoulders, feet,
ankles, knees, hips, rate onlyPhone: (918) 900-6432 Fax: (918) 392-7057cases
American Board of OrthopedicSurgery
T R MITF
Hand Surgery Brian Chalkin, D.O.* 1809 E 13 St Ste 100 Shoulder, Elbow, Hand, Wrist TulsaTulsa, OK74104
[email protected] Excl. Body Parts/Svcs:Contact: Melissa Revis Knee, Ankle, Hip, Spine, Neck,
PelvisPhone: (918) 925-3268 Fax: (918) 301-4293
American Osteopathic Board ofOrthopedic Surgery
T R
Hand Surgery Charles H. Funderburk, M.D.* 9600 Broadway Extension hands, shoulders, elbows, knees, Oklahoma Ctiy,wrists, forearm EdmondOklahoma City, OK73114
[email protected]. Body Parts/Svcs:Contact: LaDonna or Claudianeck, back, hips, feetPhone: (405) 230-9125 Fax: (405) 230-9119
American Board of OrthopedicSurgery
T R
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 9
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Hand Surgery Greg Halko, M.D.* 3301 NW 50 hands, wrists, elbows ONLY Oklahoma CityOklahoma City, OK73112
[email protected] Excl. Body Parts/Svcs:Contact: central scheduling spine, (neck, back) , shoulders or
lower extremitiesPhone: (405) 947-0911 Fax: (405) 942-5043
American Board of OrthopedicSurgery
T R MITF
Hand Surgery Daron C. Hitt, M.D. 3110 SW 89th St., Suite 200A Hand, Forearm up to, but not Oklahoma Cityincluding elbow.Oklahoma City, OK73159--790
[email protected]. Body Parts/Svcs:Contact: SchedulerAcutal elbow, unless for plasticsPhone: (405) 486-6800 Fax: (405) 426-6441
American Board of SurgeryT R
Hand Surgery Stephen W. Mihalsky, M.D. 105 S Bryant Ste 407 Hand Surgery- Elbow, Wrist, Hand EdmondEdmond, OK73034
[email protected] Excl. Body Parts/Svcs:Contact: Scheduler Neck and ShoulderPhone: (405) 348-5060 Fax: (405) 364-8750
American Board of Surgery of theHand, American Board of Surgery
T R
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 10
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Hand Surgery David B. Mokhtee, M.D. 4802 S. 109th E. Ave. fingers to elbows TulsaTulsa, OK74146
[email protected] Excl. Body Parts/Svcs:Contact: Denise 918-392-1403 Everything except Hand and Wrist-
pathology proximal to the elbowPhone: (918) 392-1400 Fax: (918) 392-1401
American Board of Surgery - HandSurgery
T
Hand Surgery M. Sean O'Brien, D.O.* 3110 SW 89th St., Suite 200C Knees, elbows, hands and shoulders Oklahoma CityOklahoma City, OK73159
[email protected] Excl. Body Parts/Svcs:Contact: Scheduler feet and anklePhone: (405) 759-2663 Fax: ( ) -
American Osteopathic Board ofOrthopedic Surgery
T R
Hand Surgery Ghazi M. Rayan, M.D.* 3366 NW Expressway Ste 700 shoulder, elbow, wrist, hand, arm Oklahoma CityOklahoma City, OK73112-4418
[email protected] Excl. Body Parts/Svcs:Contact: Barbara Jones Non-Upper Extremity, Back, Knees,
FeetPhone: (405) 945-4888 Fax: (405) 945-4889
American Board of OrthopedicSurgery/ Am Bd of Ortho Surg ofHand
T R MITF
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 11
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Hand Surgery Richard A. Ruffin, M.D.* 3301 NW 50TH ST hands, wrists, elbows, shoulders, Oklahoma CityfingersOklahoma City, OK73112
[email protected]. Body Parts/Svcs:Contact: Central SchedulingSpinePhone: (405) 947-0911 Fax: (405) 947-4263
American Board of OrthopedicSurgery, Hand Surgery
T R
Hand Surgery David Rush, M.D.* 9600 Broadway Ext Elbow, Wrist & Hand OKLAHOMA CITY &NORMANOklahoma City, OK73114
Excl. Body Parts/Svcs:Contact: LaDonna Siler Neck, BAck, Shoulder, Hip, Knee,
Ankle & FootPhone: (405) 230-9237 Fax: ( ) -
American Board of OrthopedicSurgery
T R
Hand Surgery Garrett Watts, M.D. 10507 E 91st Street Suite 350 hands, wrists, elbows, arm Broken ArrowTulsa, OK74133
[email protected] Excl. Body Parts/Svcs:Contact: Candace Rudd spine, neck, lower extremitiesPhone: (918) 451-3000 Fax: (918) 451-2700
American Board of OrthopedicSurgery
T R
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 12
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Internal Medicine S.A. Chaudhry, M.D. 5611 Mosteller Dr All Parts of the Body Oklahoma CityOklahoma City, OK73112
Excl. Body Parts/Svcs:Contact: Dr. Chaudry Genitals and Female Pelvic OrgansPhone: (405) 843-2345 Fax: (405) 843-8237
American Board of Internal MedicineT R
Internal Medicine Kenneth R. Trinidad, D.O.* 1006 W 23 St Internal Medicine-All body parts TulsaTulsa, OK74107
Excl. Body Parts/Svcs:Contact: Rhonda Pulmonary and Chemical exposure,
including moldPhone: (918) 742-4881 Fax: (918) 742-5854
Internal MedicineT R MITF
Neurology Gabriel Pitman, D.O. 401 SW 80 STE 201 Neurology-Head and Spine, Oklahoma Cityperipheral nerveOklahoma City, OK73139
[email protected]: Paula ByrdPhone: (405) 632-9090 Fax: ( ) -
American Board of NeurologyT
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 13
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Neuropsychology - Clinical John Linck, PhD 920 Stanton L Young Suite 3445 Clinical neuropsycholgy (cognition Oklahoma City& emotional)Oklahoma City, OK73104
[email protected]. Body Parts/Svcs:Contact: Garyall but listedPhone: (405) 271-4488 Fax: ( ) -
Clinical NeuropsychologyT R MITF
Neuropsychology - Clinical Russell Pella, PhD 7146 S Braden Ave Suite 500 clinical neuropsychology TulsaTulsa, OK74136
[email protected] Excl. Body Parts/Svcs:Contact: scheduler all but neuropsychology and
psychiatricPhone: (918) 488-6165 Fax: ( ) -
American Board of ClinicalNeuropsychology
R MITF
Neuropsychology Faust Bianco, Jr., Ph.D.* 7146 S Braden Ave Ste 500 Rehab Neuropsychology-Brain, TulsaNervous System, all behavioralTulsa, OK74136aspects of physicale psychologicaltraumaContact: Suzan
Phone: (918) 746-0794 Fax: (918) 746-0717Excl. Body Parts/Svcs:Children
Certification UnknownT R MITF
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 14
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Neuropsychology Terry G. Shaw, Ph.D. PO Box 3010 head, traumatic brain injury, Tulsapsychological overlayMcAlester, OK74502
[email protected]. Body Parts/Svcs:Contact: Maryall excluded except parts listed asPhone: (918) 488-6165 Fax: (918) 488-8021specialty
American Board of ProfessionalNeuropsychology
R
Neuropsychology Adam G. Sherman, Ph.D. 5512 S Lewis Ave, Ste 8 all within specialty TulsaTulsa, OK74105
[email protected] Excl. Body Parts/Svcs:Contact: Susan NonePhone: (918) 712-2885 Fax: (918) 712-9019
Certification UnknownT R
Neurosurgery Daniel Boedeker, M.D. 6767 S Yale Ave Ste A Brain, Thoracic, Lumbar, Cervical TulsaSpine, Carpal TunnelTulsa, OK74136
[email protected]. Body Parts/Svcs:Contact: Jacci Carpioall except specialtyPhone: (918) 491-3527 Fax: (918) 491-3542
Certification UnknownT R
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 15
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Neurosurgery Christopher G. Covington, M.D. Attn: Sheila Harless spine, brain, carpel tunnel Tulsa6802 S Olympia Ave Ste 300
[email protected] Tulsa, OK74063 Excl. Body Parts/Svcs:Contact: Sheila, Melissa extremitiesPhone: (918) 749-0762 Fax: (918) 744-4246
American Board of NeurologicalSurgery
T
Neurosurgery Joseph Bridger Cox, M.D. 4120 W. Memeorial Rd Neck, Back, Wrist (carpal tunnel) OKCOklahoma City, OK73120
[email protected] Excl. Body Parts/Svcs:Contact: Shehan Shoulders, Knees, lower extremitiesPhone: (405) 748-3300 Fax: ( ) -
American Board of NeurologicalSurgery
T R
Neurosurgery Emily D. Friedman, M.D. 3130 SW 89th Street, Ste. 100 Cerical, Thoracic and Lumbar Spine Oklahoma CityOklahoma City, OK73159
[email protected] Excl. Body Parts/Svcs:Contact: Esther Berger all body parts not specifiedPhone: (405) 395-2633 Fax: (405) 286-0176
American Board of NeurologicalSurgery
T R
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 16
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Neurosurgery Steven E. Gaede, M.D. 1423 Terrace Dr. #4646 spine, brain, peripheral nerve TulsainjuryTulsa, OK74159
[email protected]. Body Parts/Svcs:Contact: Schedulernon-spine orthopedic casesPhone: (918) 640-6739 Fax: ( ) -
American Board of NeurologicalSurgery
T
Neurosurgery Michael Hahn, M.D. 4120 W Memorial Rd Ste 300 spine (neck, back), wrist (carpal Oklahoma Citytunnel)Oklahoma City, OK73120
[email protected]. Body Parts/Svcs:Contact: Tammy Blehmshoulders, knees, hips, elbowsPhone: (405) 748-3300 Fax: (405) 749-1671
American Board of NeurologicalSurgery
T
Neurosurgery Daniel Harwell, MD 6802 S Olympia Ave #300 spine, brain and carpal tunnel TulsaTulsa, OK74132
[email protected] Excl. Body Parts/Svcs:Contact: Sheila Harless or Melissa Lars extremitiesPhone: (918) 749-0762 Fax: ( ) -
Certification UnknownT
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 17
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Neurosurgery Brent N. Hisey, M.D. 800 NW 9th Street, Suite 201 spine (neck, back), brain, carpal Oklahoma CitytunnelOklahoma City, OK73106Excl. Body Parts/Svcs:Contact: MarieNothing outside of cervical,Phone: (405) 979-7875 Fax: (405) 979-7880lumbar, and brain
American Board of NeurologicalSurgery
T R MITF
Neurosurgery Kyle Mangels, M.D. 6802 S Olympia Ave Ste 300 Back, Neck, Brain, Carpal Tunnel, TulsaUlnar NerveTulsa, OK74132
[email protected]. Body Parts/Svcs:Contact: Sheila Harless/Melissa LarsonLegs, Hips, JointsPhone: (918) 749-0762 Fax: (918) 744-4246
American Board of NeurologicalSurgery
T R
Neurosurgery John S. Marouk, D.O. 2128 S Atlanta PL Ste 100 spine, brain only TulsaTulsa, OK74114
[email protected] Excl. Body Parts/Svcs:Contact: Rachel Caudle all other body partsPhone: (918) 583-5131 Fax: (918) 592-0670
American Osteopathic Board ofSurgery
T R
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 18
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Neurosurgery Jeffrey Nees, M.D. 3110 SW 89th Street Suite 200E Spine, peripheral nerve OKCOklahoma City, OK73159
Excl. Body Parts/Svcs:Contact: scheduler ectensive spine deformityPhone: (405) 486-6720 Fax: ( ) -
American Board of NeurologicalSurgery
T R
Neurosurgery Stan Pelofsky, M.D. 4120 W Memorial Rd Ste 300 Head, Neck, Back, Wrist (Carpal Oklahoma CityTunnel)Oklahoma City, OK73120
[email protected]. Body Parts/Svcs:Contact: Tammyshoulders, kneesPhone: (405) 748-3300 Fax: (405) 749-1671
American Board of NeurologicalSurgery
T R
Neurosurgery Ryan F. Rahhal, M.D. 2408 E 81st Street, Suite 290 brain, spine (thoracic, lumbar, & Tulsa orcervical), carpal tunnel StillwaterTulsa, OK74137
[email protected]. Body Parts/Svcs:Contact: Michelleall ot neurosurgicalPhone: (918) 855-1255 Fax: (918) 494-9397
Certification UnknownT R
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 19
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Neurosurgery Robert L. Remondino, M.D. 4120 W Memorial Rd Ste 300 neck, back, wrists (carpal tunnel) Oklahoma CityOklahoma City, OK73120
[email protected] Excl. Body Parts/Svcs:Contact: Marlea Lynch shoulders, knees, lower extremitiesPhone: (405) 748-3300 Fax: (405) 749-1671
American Board of NeurologicalSurgery
T R
Neurosurgery W. Emery Reynolds, M.D. 4120 W Memorial Ste 202 head, spine Oklahoma CityOklahoma City, OK73120
NONEContact: SondraPhone: (405) 755-3540 Fax: (405) 755-7001
American Board of NeurologicalSurgery
T
Neurosurgery Brian E. Snell, M.D. 4120 W Memorial Rd Ste 300 spine (neck, back), wrist (carpal Oklahoma Citytunnel)Oklahoma City, OK73120
[email protected]. Body Parts/Svcs:Contact: Karryshoulders, knees, hips, elbowsPhone: (405) 748-3300 Fax: (405) 749-1671
American Board of NeurologicalSurgery
T
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 20
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Neurosurgery Caple A Spence, M.D. 8121 National Ave Ste 210 brain, spine, peripheral nerves MWCMidwest City, OK73110
[email protected]: RethaPhone: (405) 455-3393 Fax: (405) 455-7162
American Board of NeurologicalSurgery
T
Neurosurgery Ryan Tackla, MD 6802 S Olympia Ave #300 spine, brain, carpal tunnel TulsaTulsa, OK74132
[email protected] Excl. Body Parts/Svcs:Contact: Sheila or Melissa extremitiesPhone: (918) 749-0762 Fax: ( ) -
Certification UnknownT
Neurosurgery Michael Thambuswamy, MD 6802 S Olympia Ave Suite #300 spine, brain, carpal tunnel, ulnar Tulsaneuropathy, peripheral nervesTulsa, OK74132
credentialing @osbi.netExcl. Body Parts/Svcs:Contact: Sheila or MelissaorthopedicPhone: (918) 749-0762 Fax: ( ) -
Certification UnknownT
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 21
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Neurosurgery Frank J. Tomecek, M.D. 6802 S Olympia Ave Ste 300 Back, Neck, Brain, Carpal Tunnel, TulsaUlnar NerveTulsa, OK74132
[email protected]. Body Parts/Svcs:Contact: Sheila or MelissaLegs, Hips, JointsPhone: (918) 749-0762 Fax: (918) 749-8531
American Board of NeurologicalSurgery
T R
Neurosurgery Benjamin T. White, M.D. 4120 W Memorial Rd Ste 300 head, neck, back, wrist (carpal Oklahoma Citytunnel)Oklahoma City, OK73120
[email protected]. Body Parts/Svcs:Contact: Beccashoulders, knees, lower extremitiesPhone: (405) 748-3300 Fax: (405) 749-1671
American Board of NeurologicalSurgery
T R
Neurosurgery Robert J. Wienecke, M.D. 4120 W Memorial Rd Ste 300 neck, back, wrists{carpal tunnel) Oklahoma CityOklahoma City, OK73120
[email protected] Excl. Body Parts/Svcs:Contact: Marlea shoulders, knees, lower extremitiesPhone: (405) 748-3300 Fax: (405) 749-1671
American Board of NeurologicalSurgery
T R
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 22
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Neurosurgery Gregory L. Wilson, D.O. 9709 E 79 Street South brain, neck, back TulsaTulsa, OK74133
[email protected]: Traci LawleyPhone: (918) 994-4061 Fax: (918) 994-4095
Am Board of OsteopathicNeurological Surgery
T R
Neurosurgery Shihao Zhang, M.D. 6767-A S Yale Ave Brain, Spine, Peripheral Nerve for TulsaCTRTulsa, OK74136
[email protected]. Body Parts/Svcs:Contact: Shanna NeumanALL OTHERSPhone: (918) 491-3528 Fax: ( ) -
Certification UnknownT R
Occupational Medicine William R. Gillock, M.D. 7170 S Braden Ste 175 all body parts TulsaTulsa, OK74136
[email protected] Excl. Body Parts/Svcs:Contact: Sharon or Sandy nonePhone: (918) 481-0994 Fax: (918) 494-6747
American Board of Internal Medicine& Preventive Medicine
T R MITF
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 23
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Occupational Medicine John W. Hallford, D.O. 5682 W Skelly Dr occupational medicine/General TulsaPracticeTulsa, OK74107
[email protected]. Body Parts/Svcs:Contact: Meyon WardnonePhone: (918) 446-1891 Fax: (918) 446-1894
American Osteopathic Board ofFamily Physicians
R MITF
Occupational Medicine William D. Jones, M.D. 707 NW 13 St all occupational medicine (rating Oklahoma Cityonly)Oklahoma City, OK73103
[email protected]. Body Parts/Svcs:Contact: Jeannefemale reproductive system andPhone: (405) 521-8604 Fax: (405) 521-8605pediatrics
Certification Unknown R MITF
Occupational Medicine John A. Munneke, M.D., DDS 36 W Memorial Ste B9 Physical Medicine-Pain Management Oklahoma CityOklahoma City, OK73114
[email protected] Excl. Body Parts/Svcs:Contact: JoAnne Thacker PulmonaryPhone: (405) 755-9702 Fax: (405) 755-9718
Certification UnknownT R MITF
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 24
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Occupational Medicine Robert Paul, M.D. 7107 S Yale Avenue #229 all within specialty TulsaTulsa, OK74136
[email protected] Excl. Body Parts/Svcs:Contact: Linda PsychiatricPhone: (918) 496-1991 Fax: ( ) -
Certification Unknown R MITF
Occupational Medicine Carl B. Pettigrew, D.O. 6521 S Western Avenue all Oklahoma CityOklahoma City, OK73139
[email protected] Excl. Body Parts/Svcs:Contact: Karen NonePhone: (405) 239-7766 Fax: (405) 235-4895
Certification UnknownT R MITF
Occupational Medicine J. A. Snelling, D.O. PO Box 702738 Orthopedic-Knees, Ankles, Lower TulsaSpineTulsa, OK74170
noneExcl. Body Parts/Svcs:Contact: MargaretCardiac-RespiratoryPhone: (918) 749-3187 Fax: (918) 491-9925
American Board of FamilyPhysicians, Am Board of PreventiveMed.
R
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 25
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Occupational Medicine Kenneth R. Trinidad, D.O.* 1006 W 23 St Internal Medicine-All body parts TulsaTulsa, OK74107
Excl. Body Parts/Svcs:Contact: Rhonda Pulmonary and Chemical exposure,
including moldPhone: (918) 742-4881 Fax: (918) 742-5854
Internal MedicineT R MITF
Optometry Carolanne Roach, O.D. 1350 SW 89th St, Ste D2 Specializing in brain injuries, Oklahoma Citystrokes, concussions, low vision,Oklahoma City, OK73159superficial eye injuries ([email protected] foreign bodies)Contact: Linda Roach / Kristen Hoaglin
Phone: (405) 703-3163 Fax: ( ) -Excl. Body Parts/Svcs:Eye injuries with need forsiginificant need for surgicalinterventi
OptometryT R MITF
Orthopedic Surgery Kasra Ahmadinia, M.D. 2408 E 81st Street, Suite 290 Neck and Spine TulsaTulsa, OK74137
[email protected] Excl. Body Parts/Svcs:Contact: Susan head, hand, Shoulder, Knee, Ankle,
Elbow, hipPhone: (918) 855-1255 Fax: ( ) -
American Board of OrthopedicSurgery
T R MITF
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 26
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Orthopedic Surgery Gary B. Anderson, M.D.* 3301 NW 50 St knees, shoulders, hips, elbows Oklahoma CityOklahoma City, OK73112
[email protected] Excl. Body Parts/Svcs:Contact: Scheduling spine (back, neck), handsPhone: (405) 947-0911 Fax: (405) 947-0775
American Board of OrthopedicSurgery
T
Orthopedic Surgery John W. Anderson, M.D. 3301 NW 50 St Foot/Ankle, Knee Oklahoma CityOklahoma City, OK73112
[email protected] Excl. Body Parts/Svcs:Contact: Angela Back, Neck, Shoulders, Elbow,
Wrist, HipPhone: (405) 947-0911 Fax: (405) 948-5177
American Board of OrthopedicSurgery
T R MITF
Orthopedic Surgery Clint Justin Basener, D.O.* 6130 E 81ST Street Shoulders, Knees, Hips, Legs, TulsaAnkles, Feet, Elbows, Hands, ArmsTulsa, OK74137
[email protected]: AngiePhone: (918) 583-4400 Fax: (918) 583-7908
Certification UnknownT R
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 27
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Orthopedic Surgery James F. Bischoff, M.D.* 2448 East 81st Street Suite1200 Hands TulsaTulsa, OK74137
Excl. Body Parts/Svcs:Contact: Naomi Traczyk spine, elbows, shoulders, feet,
ankles, knees, hips, rate onlyPhone: (918) 900-6432 Fax: (918) 392-7057cases
American Board of OrthopedicSurgery
T R MITF
Orthopedic Surgery David Bobb, M.D. 825 E Robinson all except back & head Norman/MooreNorman, OK73071
[email protected] Excl. Body Parts/Svcs:Contact: Donna back & headPhone: (405) 364-7900 Fax: ( ) -
American Board of OrthopaedicSurgery
T R MITF
Orthopedic Surgery James Lee Bond, M.D. 3400 W Tecumseh Rd Ste 101 knees, shoulders, elbows, hips NormanNorman, OK73072
Excl. Body Parts/Svcs:Contact: Anne Miles foot, anklePhone: (405) 515-8086 Fax: (405) 360-6769
American Board of OrthopaedicSurgery
MITF
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 28
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Orthopedic Surgery Bradford Boone, M.D.* 2408 E 81st Street, Suite 290 knees, shoulders, elbows TulsaTulsa, OK74137
Excl. Body Parts/Svcs:Contact: Sheri McKown spine, hips, feet, ankles, hands &
rate only casesPhone: (918) 494-2665 Fax: (918) 494-9397
American Board of OrthopedicSurgery/Sports Medicine
T R
Orthopedic Surgery R. Tyler Boone, M.D. 2408 E 81st Street, Suite 290 neck, back TulsaTulsa, OK74137
Excl. Body Parts/Svcs:Contact: Sheri McKown hands, hips, knees, feet, ankles
shoulders, elbows, no rate only casPhone: (918) 494-2665 Fax: (918) 494-9397
American Board of OrthopedicSurgery/AmBd Ortho Surg of theSpine
T R
Orthopedic Surgery Steven P. Brantley, M.D. 3301 NW 50th ST, STE 100 Knees, Shoulders, Wrists, Ankles Oklahoma Cityand ElbowsOklahoma City, OK73112-5627
[email protected]. Body Parts/Svcs:Contact: central schedulingSpine (neck and back) , Hips andPhone: (405) 947-0911 Fax: ( ) -Hands
American Board Orthopaedic SurgeryT R MITF
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 29
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Orthopedic Surgery Christopher A. Browne, M.D. 2488 E 81st Street, Suite 290 hips, knees TulsaTulsa, OK74137
Excl. Body Parts/Svcs:Contact: Sheri McKown hands, spine, feet, ankles,
shoulders, elbows, no rate onlyPhone: (918) 494-2665 Fax: (918) 494-9397cases
American Board of OrthopedicSurgery
T R
Orthopedic Surgery James D. Cash, M.D.* 2448 East 81st Street, Suite 1520 knees, shoulders TulsaTulsa, OK74137
[email protected] Excl. Body Parts/Svcs:Contact: Hip, Hand, Elbow, Ankle, Feet,
SpinePhone: (918) 900-2520 Fax: (918) 900-2521
American Board of OrthopedicSurgery
T R
Orthopedic Surgery Brian Chalkin, D.O.* 1809 E 13 St Ste 100 Shoulder, Elbow, Hand, Wrist TulsaTulsa, OK74104
[email protected] Excl. Body Parts/Svcs:Contact: Melissa Revis Knee, Ankle, Hip, Spine, Neck,
PelvisPhone: (918) 925-3268 Fax: (918) 301-4293
American Osteopathic Board ofOrthopedic Surgery
T R
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 30
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Orthopedic Surgery Brian Clowers, M.D. 3400 W Tecumseh Ste 101 foot, ankle OKC, NormanNorman, OK73072
Excl. Body Parts/Svcs:Contact: Anne Miles all except foot & anklePhone: (405) 515-8086 Fax: ( ) -
American Board of OrthopedicSurgery
T R
Orthopedic Surgery Jimmy Harold Conway, M.D. 10001 S Western Ste 101 shoulder, knees Oklahoma CityOklahoma City, OK73139-2997
[email protected] Excl. Body Parts/Svcs:Contact: Scheduler elbows, feet, handsPhone: (405) 692-3749 Fax: (405) 692-3789
American Board of OrthopedicSurgery
T R MITF
Orthopedic Surgery Steven D. Coupens, M.D. 9800 Broadway Extension Suite 201 all body parts Oklahoma CityOklahoma City, OK73114
[email protected]: Phone: (405) 427-6776 Fax: (405) 424-5415
American Board of OrthopedicSurgery
T R MITF
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 31
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Orthopedic Surgery Thomas G. Craven, M.D. 2408 East 81st St, Ste 290 Neck and Spine TulsaTulsa, OK74137
[email protected] Excl. Body Parts/Svcs:Contact: Deidre Knee, Ankle, Elbow, Hand, Wrist,
HipPhone: (918) 855-1255 Fax: (918) 494-9355
American Board of OrthopedicSurgery
T R MITF
Orthopedic Surgery Kevin M. Dukes, M.D. 4802 S 109 E Ave shoulders TulsaTulsa, OK74146
[email protected] Excl. Body Parts/Svcs:Contact: James Taffee all but shoulderPhone: (918) 392-1403 Fax: (918) 392-1401
American Board of OrthopedicSurgery
T
Orthopedic Surgery Scott J. Dunitz, M.D. 4802 S 109 E Ave Orthopedic Surgery-Total Joint TulsaReconstruction-Hip and KneeTulsa, OK74146
[email protected]: Denis 918-392-1403Phone: (918) 392-1403 Fax: (918) 392-1401
American Board of OrthopedicSurgery
T
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 32
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Orthopedic Surgery Winston Fong, M.D. 9600 Broadway Extension Back and Neck ONLY OKC, EdmondOklahoma City, OK73114
[email protected] or [email protected] Excl. Body Parts/Svcs:Contact: LaDonna / Claudia all except spine
(shoulders,elbows,hands,wrist,hips,Phone: (405) 230-9237 Fax: (405) 230-9119knees,ankles/f
American Board of OrthopaedicSurgery
T R
Orthopedic Surgery Jeff A. Fox, M.D.* 2408 E 81st Street, Suite 290 knees, ankles, elbow, shoulders TulsaTulsa, OK74137
[email protected] Excl. Body Parts/Svcs:Contact: Danette head and spinePhone: (918) 855-1255 Fax: (918) 494-9388
American Board of OrthopedicSurgery
T R MITF
Orthopedic Surgery Charles H. Funderburk, M.D.* 9600 Broadway Extension hands, shoulders, elbows, knees, Oklahoma Ctiy,wrists, forearm EdmondOklahoma City, OK73114
[email protected]. Body Parts/Svcs:Contact: LaDonna or Claudianeck, back, hips, feetPhone: (405) 230-9125 Fax: (405) 230-9119
American Board of OrthopedicSurgery
T R
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 33
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Orthopedic Surgery Robert A. German, M.D. 9600 Broadway Extension knees, shoulders, elbows, ankles, Oklahoma City,arms, legs NormanOklahoma City, OK73114
[email protected]. Body Parts/Svcs:Contact: LaDonna / Claudiaspine, neckPhone: (405) 230-9237 Fax: (405) 230-9119
American Board of OrthopedicSurgery
T R
Orthopedic Surgery Greg Halko, M.D.* 3301 NW 50 hands, wrists, elbows ONLY Oklahoma CityOklahoma City, OK73112
[email protected] Excl. Body Parts/Svcs:Contact: central scheduling spine, (neck, back) , shoulders or
lower extremitiesPhone: (405) 947-0911 Fax: (405) 942-5043
American Board of OrthopedicSurgery
T R MITF
Orthopedic Surgery Kevin Wayne Hargrove, M.D. 101 S Saints Blvd Ste 101 Orthopaedic Surgery; Sports EdmondMedicince-Shoulders and kneesEdmond, OK73034
[email protected]. Body Parts/Svcs:Contact: Makenzi or TashaSurgical Spine CasesPhone: (405) 513-8326 Fax: (405) 513-7739
American Board of OrthopedicSurgery
T MITF
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 34
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Orthopedic Surgery Bryan Hawkins, M.D.* 2408 E 81st Street, Suite 290 ankles TulsaTulsa, OK74137
[email protected] Excl. Body Parts/Svcs:Contact: Deidre neck, spine, wrists, handsPhone: (918) 855-1255 Fax: (918) 494-9388
American Board of OrthopedicSurgery
T R MITF
Orthopedic Surgery Randall L. Hendricks, M.D. 2408 E 81st Street, Suite 290 neck, spine TulsaTulsa, OK74137
[email protected] Excl. Body Parts/Svcs:Contact: Danette shoulders, elbows, hips, knees
hands, wrists, anklePhone: (918) 855-1255 Fax: (918) 494-9388
American Board of OrthopedicSurgery
T R MITF
Orthopedic Surgery Gregory R. Holt, M.D. 1809 E 13 St Ste 100 hips, knees, shoulders, ankles TulsaTulsa, OK74104
[email protected] Excl. Body Parts/Svcs:Contact: Melissa Back, NeckPhone: (918) 925-3268 Fax: (918) 582-6060
American Board of OrthopedicSurgery
T R MITF
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 35
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Orthopedic Surgery Christopher Shane Hume, D.O. 3115 SW 89th spine (neck & back) Oklahoma CityOklahoma City, OK73159
[email protected] Excl. Body Parts/Svcs:Contact: Andrea all except specialityPhone: (405) 427-3705 Fax: ( ) -
Board EligibleT R MITF
Orthopedic Surgery Antoine I. Jabbour, M.D. 4802 S 109 E Ave knees, shoulders TulsaTulsa, OK74146
[email protected] Excl. Body Parts/Svcs:Contact: Melissa Matthews backs or necksPhone: (918) 392-1400 Fax: (918) 392-1401
American Board of OrthopedicSurgery
T
Orthopedic Surgery Thomas P. Janssen, M.D. 9600 Broadway Extension knees, hips, shoulders, feet, hands Oklahoma CityOklahoma City, OK73114
[email protected] Excl. Body Parts/Svcs:Contact: Claudia or LaDonna neck,backPhone: (405) 230-9125 Fax: (405) 230-9119
American Board of OrthopaedicSurgery
T R
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 36
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Orthopedic Surgery Daniel J. Jones, M.D. 8100 S Walker Ave Bldg A knee, shoulder, foot,egs, arms, Oklahoma CityelbowsOklahoma City, OK73139
[email protected]. Body Parts/Svcs:Contact: Alice Mataspine, neck, feet, anklesPhone: (405) 632-4468 Fax: (405) 632-4317
American Board of OrthopaedicSurgery
T R MITF
Orthopedic Surgery Paul Kammerlocher, Orthopedic 3115 SW 89th St. FEET and ANKLES Oklahoma CityOklahoma City, OK73159-7901
Contact: Phone: (405) 486-6900 Fax: ( ) -
American Boaard of OrthopedicSurgery
T
Orthopedic Surgery Michael E. Kiehn, M.D. 3301 NW 50 St Knees and Shoulders Oklahoma CityOklahoma City, OK73112
Excl. Body Parts/Svcs:Contact: Central Scheduling Feet, Hands, Back, HipsPhone: (405) 947-0911 Fax: (405) 942-5043
American Board of OrthopaedicSurgery
T R MITF
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 37
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Orthopedic Surgery Richard Kirkpatrick, M.D.* 3400 W Tecumseh Rd Ste 101 knees, shoulders, elbows, hands, Norman,hip Oklahoma CityNorman, OK73072Excl. Body Parts/Svcs:Contact: Anne Milesfoot, anklePhone: (405) 515-8086 Fax: (405) 360-6769
American Board of OrthopaedicSurgery
T R
Orthopedic Surgery Zakary A. Knutson, M.D. 3400 W Tecumseh Ste 101 hips, knees, shoulders, elbows, Norman, Edmondhands anklesNorman, OK73072Excl. Body Parts/Svcs:Contact: Ann MilesfootPhone: (405) 515-8086 Fax: ( ) -
Certification UnknownT R
Orthopedic Surgery Mark F. Kowalski, M.D. 4140 W Memorial Rd Ste 308 Shoulders, Arms, Elbows, Hands, Oklahoma CityHips, Legs, Knees, Ankles, and FeetOklahoma City, OK73120Excl. Body Parts/Svcs:Contact: Laura Shelton, Diane EnglesNeck and BackPhone: (405) 749-7031 Fax: (405) 749-7036
American Board of OrthopedicSurgery
T R
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 38
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Orthopedic Surgery Sarat Kunapuli, D.O. 2408 E 81st Street, Suite 290 Knees and hips TulsaTulsa, OK74137
Excl. Body Parts/Svcs:Contact: Shari McKown all except listedPhone: (918) 494-2665 Fax: (918) 494-9397
American Osteopathic AssociationT R
Orthopedic Surgery Ronald S. LaButti, D.O.* 2408 E 81st Street, Suite 290 Total Joint Reconstruction, Hip and TulsaKneeTulsa, OK74137
[email protected]. Body Parts/Svcs:Contact: DanetteHead, Shoulder, Ankle, Elbow, Hand,Phone: (918) 855-1255 Fax: (918) 494-9388Spine
American Osteopathic Aacademy ofOrthopedics
T R MITF
Orthopedic Surgery Bradley J. Lawson, M.D. 10507 E 91st ST, STE 350 ankle, shoulder, hip, knee, feet, TULSAelbow, hand, wristTulsa, OK74133Excl. Body Parts/Svcs:Contact: Francine CalvertnonePhone: (918) 451-3000 Fax: (918) 451-2700
American Board of OrthopaedicSurgery
T R MITF
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 39
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Orthopedic Surgery Brian A. Levings, D.O. 8100 S Walker Ave Bldg A arms, legs, shoulders, knees, Oklahoma CityelbowsOklahoma City, OK73139
[email protected]. Body Parts/Svcs:Contact: Alic Mataback, neck, feet, anklesPhone: (405) 632-4468 Fax: (405) 632-4317
American Osteopathic Board ofOrthopaedic Surgery
T R MITF
Orthopedic Surgery Alan G. Lewis, M.D. 2448 East 81st Street, Suite 1520 feet and knees TulsaTulsa, OK74137
Excl. Body Parts/Svcs:Contact: Everything but feet and kneesPhone: (918) 900-2520 Fax: (918) 900-2521
Premier Orthopedic Specialists ofTulsa
T
Orthopedic Surgery J. Patrick Livingston, M.D. 1211 N Shartel Suite 800 orthopedic surgery, neck, back, Oklahoma Cityshoulders, hips, arms, legs, hands,Oklahoma City, OK73103feet
Contact: DorisExcl. Body Parts/Svcs:Phone: (405) 463-0407 Fax: (405) 463-0425head, brain, lungs, hearturogenital, gastrointestinal
American Board of OrthopedicSurgery
R MITF
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 40
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Orthopedic Surgery Jay D. Lorton, M.D. 2408 E 81st Street, Suite 290 knees, shoulders, elbows TulsaTulsa, OK74137
Excl. Body Parts/Svcs:Contact: Sheri McKown spine, hands, hips, feetPhone: (918) 494-2665 Fax: (918) 494-9397
American Board of OrthopedicSurgery
T R
Orthopedic Surgery Paul D. Maitino, D.O. 3110 SW 89 Street Ste 200D hips, knees, shoulders Oklahoma CityOklahoma City, OK73159
[email protected] Excl. Body Parts/Svcs:Contact: Myra headPhone: (405) 680-5633 Fax: (405) 735-6435
Orthopedic SurgeryT R MITF
Orthopedic Surgery Bradley Margo, M.D. PO BOX 268981 shoulders, knees Oklahoma City,Norman, EdmondOklahoma City, OK73126-8981
[email protected] Excl. Body Parts/Svcs:Contact: Claudia backs, necks, hips, feet, handsPhone: (405) 230-9125 Fax: (405) 230-9119
American Board of OrthopaedicSurgery
T R
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 41
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Orthopedic Surgery Robert Marsh, D.O. 2408 E 81st Street, Suite 290 all body parts but spine and neck TulsaTulsa, OK74137
Excl. Body Parts/Svcs:Contact: Sheri McKown spine and neckPhone: (918) 494-2665 Fax: (918) 494-9397
American Osteopathic AssociationT R
Orthopedic Surgery James C. Mayoza, M.D. 6122 E 61 St Orthopedic surgery all body parts TulsaTulsa, OK74136-2117
Contact: Nicci or MorgiePhone: (918) 492-3133 Fax: (918) 493-2215
American Board of OrthopedicSurgery
T R MITF
Orthopedic Surgery Yogesh Mittal, M.D. 1809 E 13 St Ste 100 Orthopedic Surgeon-Total Joint- TulsaKnees-HipsTulsa, OK74104
[email protected]. Body Parts/Svcs:Contact: Melissa RevisspinePhone: (918) 925-3268 Fax: (918) 301-4293
American Board of OrthopaedicSurgery
T R
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 42
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Orthopedic Surgery Mac E. Moore, M.D. 3130 S.W. 89th Street Suite 100 shoulders, elbows, knees Oklahoma CityOklahoma City, OK73159
Excl. Body Parts/Svcs:Contact: Scheduler lumbar/cervicalPhone: (405) 692-3737 Fax: (405) 692-3707
American Board of OrthopaedicSurgery
T R MITF
Orthopedic Surgery Jeffrey R. Morris, D.O.* 6130 E 81st Street shoulder, hand, wrist, hip, knee, Tulsaankles & total joint replacementsTulsa, OK74137Excl. Body Parts/Svcs:Contact: Angie Foyilneck, spinePhone: (918) 583-4400 Fax: (918) 583-7908
American Osteopathic Board ofOrthopedfic Surgery
T R MITF
Orthopedic Surgery Gerardo Myrin, MD 3115 SW 89th Orthopedic Oklahoma CityOklahoma City, OK73159
[email protected]: schedulerPhone: (405) 486-6880 Fax: ( ) -
American Board of OrthopedicSurgery
T R
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 43
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Orthopedic Surgery Ryan L. Nelson, D.O 9800 Broadway Extension, Suite 201 Orthopedic Surgery (Shoulder, EdmondElsbow, Knee, Trauma/Fractures Hip,Oklahoma City, OK73114Wrist, Ankle)[email protected]
Contact: SchedulerExcl. Body Parts/Svcs:Phone: (405) 330-8847 Fax: ( ) -none
Certification UnknownT R
Orthopedic Surgery David E. Nonweiler, M.D. 2408 E 81st Street, Suite 290 shoulders, knees TulsaTulsa, OK74137
[email protected] Excl. Body Parts/Svcs:Contact: Sheri Neck and SpinePhone: (918) 855-1255 Fax: (918) 494-9388
American Board of OrthopedicSurgery
T R MITF
Orthopedic Surgery M. Sean O'Brien, D.O.* 3110 SW 89th St., Suite 200C Knees, elbows, hands and shoulders Oklahoma CityOklahoma City, OK73159
[email protected] Excl. Body Parts/Svcs:Contact: Scheduler feet and anklePhone: (405) 759-2663 Fax: ( ) -
American Osteopathic Board ofOrthopedic Surgery
T R
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 44
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Orthopedic Surgery James M. Odor, M.D. 14100 Parkway Commons Dr Ste 200 Spine surgery (Neck and entire Oklahoma CitySpine)Oklahoma City, OK73134
[email protected]. Body Parts/Svcs:Contact: Andrea TiffanyAmything NOT connected with thePhone: (405) 242-4345 Fax: (405) 242-4333spine (neck and back)
American Board of OrthopedicSurgery
T R MITF
Orthopedic Surgery L. Todd Olsen, D.O. Olsen Orthopedics knees, shoulders MIDWEST CITY1140 S Douglas Blvd
[email protected] Midwest City, OK73130 Excl. Body Parts/Svcs:Contact: Andrea backsPhone: (405) 869-4035 Fax: (405) 733-7820
American Osteopathic Board ofOrthopedic Surgery
T R MITF
Orthopedic Surgery Victor R. Palomino, D.O.* 1809 E 13 St Ste 100 Orthopedics; Sports Medicine TulsaTulsa, OK74104
[email protected] Excl. Body Parts/Svcs:Contact: Melissa 918-925-3268 Back, Foot/ankle, handPhone: (918) 582-6800 Fax: ( ) -
American Osteopathic BoardT R
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 45
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Orthopedic Surgery Kris Parchuri, D.O. 8165 S Mingo Road Ste 201 spine TulsaTulsa, OK74133
[email protected] Excl. Body Parts/Svcs:Contact: Tasha hands, wrists, feet, elbows, anklesPhone: (918) 286-3124 Fax: (539) 664-4288
AOAT R MITF
Orthopedic Surgery Andrew B Parkinson, M.D. 14100 Parkway Commons Dr. Suite 101 Neck, Back, Spine Oklahoma CityOklahoma City, OK73134
Excl. Body Parts/Svcs:Contact: central scheduling All Excpet SpecialityPhone: (405) 463-3370 Fax: (405) 463-3371
American Board of OrthopaedicSurgery
T
Orthopedic Surgery Ghazi M. Rayan, M.D.* 3366 NW Expressway Ste 700 shoulder, elbow, wrist, hand, arm Oklahoma CityOklahoma City, OK73112-4418
[email protected] Excl. Body Parts/Svcs:Contact: Barbara Jones Non-Upper Extremity, Back, Knees,
FeetPhone: (405) 945-4888 Fax: (405) 945-4889
American Board of OrthopedicSurgery/ Am Bd of Ortho Surg ofHand
T R MITF
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 46
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Orthopedic Surgery Vytautas M. Ringus, M.D. 825 E Robinson foot and ankle NormanNorman, OK73071
[email protected] Excl. Body Parts/Svcs:Contact: Taylor nonePhone: (405) 364-7900 Fax: (405) 310-6866
Certification UnknownT R MITF
Orthopedic Surgery Richard A. Ruffin, M.D.* 3301 NW 50TH ST hands, wrists, elbows, shoulders, Oklahoma CityfingersOklahoma City, OK73112
[email protected]. Body Parts/Svcs:Contact: Central SchedulingSpinePhone: (405) 947-0911 Fax: (405) 947-4263
American Board of OrthopedicSurgery, Hand Surgery
T R
Orthopedic Surgery Blake Shockley, M.D. 2408 E 81st Street, Suite 290 shoulder, elbow, hip, knee and Tulsa areaankleTulsa, OK74137
[email protected]. Body Parts/Svcs:Contact: Deidrespine, handPhone: (918) 855-1255 Fax: (918) 494-9388
American Board of OrthopedicSurgery
T R MITF
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 47
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Orthopedic Surgery Sheryl C. Smith, M.D. 3115 SW 89TH Street foot, ankle Oklahoma CityOklahoma City, OK73159-7901
[email protected] Excl. Body Parts/Svcs:Contact: Scheduler all except foot & anklePhone: (405) 419-5610 Fax: ( ) -
Certification UnknownT
Orthopedic Surgery Cheng-Lun Soo, M.D. 9821 S May Ave Suite B spine, neck, lumbar, cervical Oklahoma CityOklahoma City, OK73159
[email protected] Excl. Body Parts/Svcs:Contact: Celia Williams all except neck and backPhone: (405) 631-4263 Fax: (405) 703-1583
American Board of OrthopedicSurgery
T R MITF
Orthopedic Surgery Wesley Michael Stotler, D.O. 4802 S 109 E Ave foot, ankle TulsaTulsa, OK74146
[email protected] Excl. Body Parts/Svcs:Contact: Liz Klawitter all except feet and anklesPhone: (918) 392-1403 Fax: (918) 392-1401
American Osteopathic Board ofOrthopedic Surgery
T
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 48
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Orthopedic Surgery Robert S. Unsell, M.D. 10001 S Western Ste 101 hands, wrist, elbows Oklahoma CityOklahoma City, OK73139
[email protected] Excl. Body Parts/Svcs:Contact: Shoulders, Spine, Lower ExtremityPhone: (405) 692-3700 Fax: (405) 923-3783
Certification UnknownT R MITF
Orthopedic Surgery Jeremy Woodson, M.D. PO Box 268981 Shoulders, Elbows, Hips, Knees, OKC and LawtonAnklesOKC, OK73126-8981
[email protected]. Body Parts/Svcs:Contact: LaDonna SilerNecks and BacksPhone: (405) 230-9237 Fax: ( ) -
American Board of OrthopedicSurgery
T R
Orthopedic Surgery Gregory J. Zeiders, D.O. 3414 NW 135TH ST hands, wrists, elbows, shoulders, Edmondfeet, ankles, knees, hipsOklahoma City, OK73120
[email protected]. Body Parts/Svcs:Contact: LindsayComplex Hand or SpinePhone: (405) 753-1100 Fax: (405) 753-5370
American Osteopathic Board ofOrthopedic Surgery
T R
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 49
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Orthopedics Jeffrey Cunningham, M.D.* 2408 E 81st Street, Suite 290 Head/Concussion TulsaTulsa, OK74137
Contact: MichellePhone: (918) 855-1255 Fax: ( ) -
American Board Family Medicine /Sports Medicine
T R MITF
Orthopedics Joel M. Davis, M.D. 941 W I-35 Frontage Rd Bldg 164 Foot and Ankle EdmondEdmond, OK73034
[email protected] Excl. Body Parts/Svcs:Contact: Kristi SpinePhone: (405) 768-1600 Fax: ( ) -
Certification UnknownT R MITF
Orthopedics William Bentley Edmonds, M.D. 9600 Broadway Extension foot, ankle Oklahoma City,Edmond, NormanOklahoma City, OK73114
[email protected] Excl. Body Parts/Svcs:Contact: LaDonna Sigler all except foot and anklePhone: (405) 230-9237 Fax: (405) 230-9119
American Board of OrthopaedicSurgery
T R
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 50
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Orthopedics David Holden, M.D. 9600 Broadway Extension knees & shoulders only Oklahoma City,NormanOklahoma City, OK73114
[email protected] Excl. Body Parts/Svcs:Contact: Lynn Stokes Spine, Neck, Hip, Ankles, Feet,
Elbows, HandsPhone: (405) 230-9466 Fax: (405) 230-9119
American Board of OrthopaedicSurgery & Sports Medicine
T
Orthopedics Michael Brandon Johnson, M.D. 9800 Broadway Extension Suite 203 all within specialty OKCOklahoma City, OK73114
[email protected] Excl. Body Parts/Svcs:Contact: Scheduler SpinePhone: (405) 424-5417 Fax: (405) 424-5418
Certification UnknownT
Orthopedics Faustino Kazenske, D.O. 3301 NW 50th Street shoulders, knees, elbows, hips and Oklahoma CityanklesOklahoma City, OK73112Excl. Body Parts/Svcs:Contact: Central Schedulinghands, feet, backPhone: (405) 947-0911 Fax: ( ) -
American Board Orthopaedic SurgeryT R MITF
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 51
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Orthopedics Richard Kirkpatrick, M.D.* 3400 W Tecumseh Rd Ste 101 knees, shoulders, elbows, hands, Oklahoma City,hip NormanNorman, OK73072Excl. Body Parts/Svcs:Contact: Anne Milesfoot, anklePhone: (405) 515-8086 Fax: (405) 360-6769
American Board of OrthopaedicSurgery
T R
Orthopedics Laura R. Luick, M.D. 3115 SW 89th Street FOOT & ANKLE OKLAHOMA CITYOklahoma City,, OK73159-7901
Contact: SchedulerPhone: (405) 486-6800 Fax: ( ) -
OK State Med Board/BOC Certified inAthletic Train
T R
Orthopedics David Rush, M.D.* 9600 Broadway Ext Elbow, Wrist & Hand OKLAHOMA CITY &NORMANOklahoma City, OK73114
Excl. Body Parts/Svcs:Contact: LaDonna Siler Neck, BAck, Shoulder, Hip, Knee,
Ankle & FootPhone: (405) 230-9237 Fax: ( ) -
American Board of OrthopedicSurgery
T R
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 52
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Orthopedics Austin Taylor, M.D. PO Box 268981 Shoulders, Knees, Hips OKC and EDMONDOklahoma City, OK73126-8981
[email protected] Excl. Body Parts/Svcs:Contact: LaDonna Siler Neck, Back, Elbows, Wrists, Hands,
Ankles, FeetPhone: (405) 230-9237 Fax: ( ) -
American Board of OrthopedicSurgery
T R
Otolaryngology Alen Munson Fuller, M.D. 1725 E 19 St Ste 100 Hearing Loss Non Surgical TulsaTulsa, OK74104
[email protected] Excl. Body Parts/Svcs:Contact: Betsi surgical casesPhone: (918) 742-7376 Fax: (918) 743-2117
American Board of OtolaryngologyT R
Otolaryngology Tom A Hamilton, D.O. 6802 S Olympia Ave W Ste 200 Ear, Nose and Throat TulsaTulsa, OK74132
[email protected] Excl. Body Parts/Svcs:Contact: Martha or Doris All OthersPhone: (918) 388-9740 Fax: ( ) -
AOBOOT R MITF
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 53
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Physical Medicine and Donald E. Adams, M.D. 1616 S Kelly pain management EdmondRehabilitation Edmond, OK73013-3651
[email protected] Excl. Body Parts/Svcs:Contact: Joann feet, anklesPhone: (405) 330-0015 Fax: (405) 330-0092
American Board of Medicine &Rehabilitation & Pain Medicine
T R
Physical Medicine and Archana Barve, M.D. 3613 NW 56 STREET STE 140 sports medicine, physical medicine Oklahoma CityRehabilitation & rehabilitationOklahoma City, OK73112
[email protected]: Stacey/SergioPhone: (405) 949-6481 Fax: (405) 795-5909
American Board of PhysicalMedicine/Rehabilitation
T MITF
Physical Medicine and Michael S. Brown, M.D. 4120 W Memorial Rd Ste 118 physiatry - head (skeletal), neck, Oklahoma CityRehabilitation spine upper and lower extremities,Oklahoma City, OK73120
nerve and joint [email protected]: Cecylia/Jean
Excl. Body Parts/Svcs:Phone: (405) 748-4700 Fax: (405) 748-5638narcotic pain management, RSD
American Academy of PhysicalMedicine/Rehab
T R
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 54
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Physical Medicine and Aaron McGuire, DO 5591 S Lewis Ave muskuloskeletal system, spinal cord Tulsa andRehabilitation injury, traumatic brain injury Oklahoma CityTulsa and Oklahoma City, OK74105
[email protected]: Phone: (918) 488-8285 Fax: ( ) -
Physical Medicine andRehabilitation
T R MITF
Physical Medicine and Darryl Dermot Robinson, M.D. 3110 SW 89 Ste 102 Physical Medicine and Rehab Oklahoma CityRehabilitation Oklahoma City, OK73159
[email protected] Excl. Body Parts/Svcs:Contact: Scheduler NonePhone: (405) 703-4950 Fax: (405) 703-4955
American Board of Physical Medicineand Rehab-Pain Management
T R
Physical Medicine and Kathleen Sisler, Orthopedic/Amputations 12800 S Memorial Dr., Ste D P M & R, EMGS, SPINE, PERIPHERALTULSARehabilitation JOINTS, AMPUTATIONSBixby, OK74008
[email protected]. Body Parts/Svcs:Contact: DeidreTRAUMATIC BRAINPhone: (915) 855-1255 Fax: ( ) -INJURY/CONCUSSIONS/SCI (SPINAL CORDINJURY)
American Board of Physical Medicineand Rehab
T
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 55
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Physical Medicine and Jonathan B. Stone, D.O. 700 NW 7 Street Ste 115 all within speciality chronic Oklahoma CityRehabilitation medication management, continuingOklahoma City, OK73102
medical [email protected]: LisaPhone: (405) 601-5899 Fax: (405) 601-5903
American Board of Physical Medicineand Rehabilitation
T
Physical Medicine and D. Brent Tipton, M.D. 5100 N Brookline Ste 530 muscles and nerves Oklahoma CityRehabilitation Oklahoma City, OK73112
[email protected] Excl. Body Parts/Svcs:Contact: Leti Ramirez heart, lungs, GI, Renal, medical
maintenance, pain managementPhone: (405) 604-6652 Fax: (405) 604-6653
American Board of PhysicalMedicine/Rehabilitation/Electrodiagnos
T R
Plastic Surgery Mehdi N. Adham, M.D.* 8100 S Walker Ave Bldg A plastic & reconstructive surgery of Oklahoma Cityhands and wristsOklahoma City, OK73139
[email protected]. Body Parts/Svcs:Contact: Alice Mata or Becky Tokarall except plastic surgery ofPhone: (405) 632-4468 Fax: (405) 632-4317hands/wrists
American Board of Plastic Surgery &Am Bd Plastic Surg of Hand
T R MITF
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 56
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Podiatry Andronica Handie, Podiatry 9709 E 79th Street Foot and Ankle surgery TULSATulsa, OK74133
[email protected]: Traci LawleyPhone: (918) 994-4061 Fax: ( ) -
American Board of PodiatricMedicine
T R
Podiatry Scott Morris, DPM 3001 S Telephone Rd Suite B foot and ankle MooreMoore, OK73160
Contact: MaryPhone: (405) 794-6691 Fax: ( ) -
Certification UnknownT
Podiatry Richard J Traczyk, II, D.P.M. 4205 McAuley Blvd Ste 465 foot, ankle Oklahoma CityOklahoma City, OK73120
[email protected] Excl. Body Parts/Svcs:Contact: Lanae No ankle fusionsPhone: (405) 755-7600 Fax: (405) 755-7680
ABMSPT R MITF
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 57
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Psychiatry Siavash Nael, M.D. 4720 S Western Ave Chronic Pain Management, psychiatry Oklahoma CityOklahoma City, OK73109-3834
[email protected] Excl. Body Parts/Svcs:Contact: Susie Jones No longer do inpatient
admissions/treatmentPhone: (405) 634-5529 Fax: (405) 634-1673
American Board of Pyschiatry andNeurology
T R
Psychology - Clinical Faust Bianco, Jr., Ph.D.* 7146 S Braden Ave Ste 500 Rehab Neuropsychology-Brain, TulsaNervous System, all behavioralTulsa, OK74136aspects of physicale psychologicaltraumaContact: Suzan
Phone: (918) 746-0794 Fax: (918) 746-0717Excl. Body Parts/Svcs:Children
Certification UnknownT R MITF
Psychology - Clinical David E. Johnsen, Ph.D. 2601 NW Expway Ste 410 W Neuropsychology, Psychology, Oklahoma CityChronic Pain (head/brain)Oklahoma City, OK73112
[email protected]: Sarah BaskervillePhone: (405) 755-8576 Fax: (405) 755-6026
Certification UnknownT R
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 58
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Psychology - Clinical Edgar J. Kranau, Ph.D.* PO Box 14082 psychological overlay, pain TulsamanagementTulsa, OK74159-4082
[email protected]. Body Parts/Svcs:Contact: selfNonePhone: (918) 712-9020 Fax: (918) 712-9021
Certification UnknownT R MITF
Psychology Stephen D. Carella, Ph.D. 3035 NW 63 Ste 103 psychological overlay Oklahoma CityOklahoma City, OK73116
[email protected] Excl. Body Parts/Svcs:Contact: Becky Provide only outpatient evaulations
and treatmentPhone: (405) 840-4212 Fax: (405) 840-4258
Certification UnknownT
Psychology Edgar J. Kranau, Ph.D.* PO Box 14082 psychological overlay, pain TulsamanagementTulsa, OK74159-4082
[email protected]. Body Parts/Svcs:Contact: selfNonePhone: (918) 712-9020 Fax: (918) 712-9021
Certification UnknownT R MITF
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 59
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Pulmonary Diseases Dennis M. Parker, M.D. 3366 NW Expressway Ste 660 pulmonary (lungs) Oklahoma CityOklahoma City, OK73112
Excl. Body Parts/Svcs:Contact: Lisa Burgess 405-947-3345 all except respiratory diseasePhone: (405) 947-3345 Fax: (405) 949-0849
American Board of InternalMedicine, Am Bd - Pulmonary Disease
T
Sports Medicine Gary B. Anderson, M.D.* 3301 NW 50 St knees, shoulders, hips, elbows Oklahoma CityOklahoma City, OK73112
[email protected] Excl. Body Parts/Svcs:Contact: Scheduling spine (back, neck), handsPhone: (405) 947-0911 Fax: (405) 947-0775
American Board of OrthopedicSurgery
T
Sports Medicine Clint Justin Basener, D.O.* 6130 E 81ST Street Shoulders, Knees, Hips, Legs, TulsaAnkles, Feet, Elbows, Hands, ArmsTulsa, OK74137
[email protected]: AngiePhone: (918) 583-4400 Fax: (918) 583-7908
Certification UnknownT R
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 60
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Sports Medicine Bradford Boone, M.D.* 2408 E 81st Street, Suite 290 knees, shoulders, elbows TulsaTulsa, OK74137
Excl. Body Parts/Svcs:Contact: Sheri McKown spine, hips, feet, ankles, hands &
rate only casesPhone: (918) 494-2665 Fax: (918) 494-9397
American Board of OrthopedicSurgery/Sports Medicine
T R
Sports Medicine James D. Cash, M.D.* 2448 East 81st Street, Suite 1520 knees, shoulders TulsaTulsa, OK74137
[email protected] Excl. Body Parts/Svcs:Contact: Hip, Hand, Elbow, Ankle, Feet,
SpinePhone: (918) 900-2520 Fax: (918) 900-2521
American Board of OrthopedicSurgery
T R
Sports Medicine Jeffrey Cunningham, M.D.* 2408 E 81st Street, Suite 290 Head/Concussion TulsaTulsa, OK74137
Contact: MichellePhone: (918) 855-1255 Fax: ( ) -
American Board Family Medicine /Sports Medicine
T R MITF
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 61
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Sports Medicine Jeff A. Fox, M.D.* 2408 E 81st Street, Suite 290 knees, ankles, elbow, shoulders TulsaTulsa, OK74137
[email protected] Excl. Body Parts/Svcs:Contact: Danette head and spinePhone: (918) 855-1255 Fax: (918) 494-9388
American Board of OrthopedicSurgery
T R MITF
Sports Medicine Bryan Hawkins, M.D.* 2408 E 81st Street, Suite 290 ankles TulsaTulsa, OK74137
[email protected] Excl. Body Parts/Svcs:Contact: Deidre neck, spine, wrists, handsPhone: (918) 855-1255 Fax: (918) 494-9388
American Board of OrthopedicSurgery
T R MITF
Sports Medicine Ronald S. LaButti, D.O.* 2408 E 81st Street, Suite 290 Total Joint Reconstruction, Hip and TulsaKneeTulsa, OK74137
[email protected]. Body Parts/Svcs:Contact: DanetteHead, Shoulder, Ankle, Elbow, Hand,Phone: (918) 855-1255 Fax: (918) 494-9388Spine
American Osteopathic Aacademy ofOrthopedics
T R MITF
* Physician has multiple specialties.
OKLAHOMA WORKERS' COMPENSATION COMMISSION AND COURT OF EXISTING CLAIMSDate: 03/01/2021 LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS Rpt ID: IMESPTime: 08:15 (Alphabetical by Specialty) Page: 62
As of January 1, 2021
Specialty Physician/Contact Info Mailing Address Body Parts/Type of Services/ City of ExamBoard Certified
Sports Medicine Jason M. Leinen, M.D.* 3110 SW 89th Suite 102 all family & sports medicine, pain Oklahoma Citymanagement (evaluate all bodyOklahoma City, OK73159parts)[email protected]
Contact: SchedulerExcl. Body Parts/Svcs:Phone: (405) 703-3611 Fax: (405) 703-3711none
American Board of Family MedicineT
Sports Medicine Jeffrey R. Morris, D.O.* 6130 E 81st Street shoulder, hand, wrist, hip, knee, Tulsaankles & total joint replacementsTulsa, OK74137Excl. Body Parts/Svcs:Contact: Angie Foyilneck, spinePhone: (918) 583-4400 Fax: (918) 583-7908
American Osteopathic Board ofOrthopedfic Surgery
T R MITF
Sports Medicine Victor R. Palomino, D.O.* 1809 E 13 St Ste 100 Orthopedics; Sports Medicine TulsaTulsa, OK74104
[email protected] Excl. Body Parts/Svcs:Contact: Melissa 918-925-3268 Back, Foot/ankle, handPhone: (918) 582-6800 Fax: ( ) -
American Osteopathic BoardT R
* Physician has multiple specialties.