LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS ...
Date: 02/21/2014 Time: 14:36 Specialty Anesthesiology
Anesthesiology
Anesthesiology
LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS
(Alphabetical by Specialty) As of January 1, 2014
Rpt ID: IMESP Page: 1
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
City of Exam
Ahmed Amayem, M.D.
Contact: Melissa Phone: (405) 632-1783 Fax: ( ) -
1145 SW 74 St, Bldg I Ste 100 Oklahoma City, OK73139
C. Scott Anthony, D.O.
jan@ Contact: Jan Phone: (918) 513-3226
Fax: (918) 447-9308
6802 S Olympia Ave Ste 100 Tulsa, OK74132-1823
Grigory Chernyak, M.D.
gregory chernyak@ Contact: Marce Phone: (405) 431-0804 Fax: ( ) -
105 S Bryant Ste 404 Edmond, OK73034
pain management
Excl. Body Parts/Svcs: head injuries, abdominal pain, complicated multi organ medical cases
American Board of Anesthesiology T
pain management - all body parts
Excl. Body Parts/Svcs: None
American Board of Anesthesiology T
pain management
Excl. Body Parts/Svcs: all except specialty
American Board of Anesthesiology T
Oklahoma City Tulsa Edmond
* Physician has multiple specialties.
Date: 02/21/2014 Time: 14:36 Specialty Anesthesiology
Anesthesiology
Anesthesiology
LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS
(Alphabetical by Specialty) As of January 1, 2014
Rpt ID: IMESP Page: 2
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
City of Exam
Richard A. DuBose, M.D.
2000 S Wheeling Ave Ste 600 Tulsa, OK74104
Contact: Pat Phone: (918) 742-7030 Fax: (918) 745-6284
David P. Ellis, M.D.
Contact: Jennifer Phone: (405) 232-8003 Fax: ( ) -
701 NE 10 Street Oklahoma City, OK73104
Terry M. Gile, D.O.
Contact: Pat Phone: (918) 742-7030 Fax: ( ) -
3204 W Okmulgee Muskogee, OK74401
all pain management
Tulsa
Excl. Body Parts/Svcs: all except pain management
American Board of Anesthesiology T
pain management/interventional pain medicine/spinal cord stimulators Excl. Body Parts/Svcs: headache
Oklahoma City
American Board of Anesthesiology Pain Medicine
T R MITF
all pain management
Muskogee
Excl. Body Parts/Svcs: all except pain management
Am Osteopathic Board of Anesthesiology/Pain Mngmt
T
* Physician has multiple specialties.
Date: 02/21/2014 Time: 14:36 Specialty Anesthesiology
Anesthesiology
Anesthesiology
LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS
(Alphabetical by Specialty) As of January 1, 2014
Rpt ID: IMESP Page: 3
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
City of Exam
Frank J. Hackl, M.D.
2448 E 81 Street ste 363 Tulsa, OK74137
Contact: Angie Phone: (918) 477-5950 Fax: (918) 447-5951
Gerald R. Hale, D.O.
Contact: Brenda Phone: (918) 477-5943 Fax: ( ) -
2448 E 81 Ste 363 Tulsa, OK74137
Martin L. Martucci, M.D.
2000 S Wheeling Ste 600 Tulsa, OK74104
Contact: Jamie Phone: (918) 742-7030 Fax: (918) 742-9958
Pain Management
Tulsa
Excl. Body Parts/Svcs: female health issues
American Board of Anesthesiology Pain Medicine
T
pain management
Tulsa
Excl. Body Parts/Svcs: all except pain management cases
American Osteopathic Board of Anesthesiology & Pain Management
T
pain management
Tulsa
Excl. Body Parts/Svcs: None within specialty
American Board of Anesthesiology T
* Physician has multiple specialties.
Date: 02/21/2014 Time: 14:36 Specialty Anesthesiology
Anesthesiology
Anesthesiology
LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS
(Alphabetical by Specialty) As of January 1, 2014
Rpt ID: IMESP Page: 4
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
City of Exam
Daniel G. Morris, D.O.*
Contact: scheduling Phone: (918) 935-3240 Fax: (918) 935-3241
2811 E 15 Street Ste 102 Tulsa, OK74104
Michael Chad Owens, D.O.
Contact: Barbara Phone: (580) 234-7246 Fax: ( ) -
427 E Cherokee Enid, OK73701
Jayen H. Patel, M.D.
Contact: appt desk Phone: (918) 935-3240 Fax: (918) 935-3241
2811 E 15 Street Ste 102 Tulsa, OK 7410-4
Pain Management Only
Tulsa
American Osteopathic Board of Anesthesiology-Pain Management
T R MITF
Interventional Pain Management
Enid
(total body)
American Board of Anesthesiology T
pain management (neck, back, leg, hand headaches, RSD)
Excl. Body Parts/Svcs: eye, foot, pelvis, elbow, rist, brain, ear
American Board of Anesthesiology T
Tulsa
* Physician has multiple specialties.
Date: 02/21/2014 Time: 14:36 Specialty Anesthesiology
Anesthesiology
Anesthesiology
LIST OF QUALIFIED INDEPENDENT MEDICAL EXAMINERS
(Alphabetical by Specialty) As of January 1, 2014
Rpt ID: IMESP Page: 5
Physician/Contact Info
Mailing Address
Body Parts/Type of Services/ Board Certified
City of Exam
Terrell, R. Phillips, D.O.
401 SW 80 Street Ste 101 Oklahoma City, OK73139
Contact: Tammy Phone: (405) 601-4227 Fax: (405) 601-4237
Justin Porter, M.D.
justinportermd@ Contact: Neile Phone: (405) 242-4100 Fax: (405) 775-9356
3601 NW 138 Street Ste 200 Oklahoma City, OK73134
Andreas "Andrew" Revelis, M.D.
2000 S Wheeling Ave Ste 600 Tulsa, OK74104
Contact: Pat Phone: (918) 742-7030 Fax: (918) 742-9958
Pain Management
Oklahoma City
Excl. Body Parts/Svcs: none within specialty
American Osteopathic Board of Anesthesiology
T R MITF
Pain Management
Oklahoma City
Excl. Body Parts/Svcs: pelvic pain, vaginal pain, rectal pain
Certification Unknown
T R MITF
pain management
Tulsa
Excl. Body Parts/Svcs: None
Certification Unknown T
* Physician has multiple specialties.
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