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Last Update: Thursday, September 26, 2024 6:51 PM CDT
Next Update: Friday, September 27, 2024 2:50 AM CDT
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PROVINE, JOHN EDWARD
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| Practice Address: |
RT 1 BOX 77
POND CREEK OK 73766-9737
Address last updated on 12/23/1999 |
| Phone #: |
(580) 635-2264 |
| Fax #: |
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| County: |
GRANT |
| License: |
10457 |
| Dated: |
3/17/1975 |
| Expires: |
3/1/2004 |
| License Type: |
Medical Doctor |
| Specialty: |
Pediatrics |
|
| Status: |
Inactive |
| Status Class: |
Physician Emeritus |
| Restricted to: |
|
| Registered to Dispense: |
NO |
| Medical School: |
Univ Of Ok Coll Of Med, Oklahoma City Ok 73190 |
| Graduated: |
5 /
1972 |
| CME Year: |
2004 |
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Pending and/or Past Disciplinary Actions:
No Disciplinary Action Taken.
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All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
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| Certifications: |
AMERICAN BOARD OF PEDIATRICS |
| New Patients: |
No |
| Medicaid: |
No |
| Medicare: |
No |
| |
|
| HMO/PPO: |
None listed |
| Hospital Privileges: |
None listed |
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