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Next Update: Thursday, December 19, 2024 12:00 PM CST
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ROTH, RUSSELL BLANCHARD
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This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.
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| Practice Address: |
3401 W BROADWAY
MUSKOGEE WOMENS CLINIC
MUSKOGEE OK 74401
Address last updated on 5/7/2015 |
| Phone #: |
(918) 687-5477 |
| Fax #: |
(918) 687-5481 |
| County: |
MUSKOGEE |
| License: |
10502 |
| Dated: |
5/12/1975 |
| Expires: |
5/1/2015 |
| License Type: |
Medical Doctor |
| Specialty: |
Obstetrics & Gynecology |
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| Status: |
Inactive |
| Status Class: |
Expired License |
| Restricted to: |
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| Registered to Dispense: |
NO |
| Medical School: |
Wayne State Univ SOM, Detroit Mi 48201 |
| Graduated: |
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1969 |
| CME Year: |
2016 |
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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 OBSTETRICS AND GYNECOLOGY |
| New Patients: |
Yes |
| Medicaid: |
Yes |
| Medicare: |
Yes |
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| HMO/PPO: |
Blue Cross Blue Shield-Blue Preferred
Blue Cross Blue Shield-Blue Traditional
Blue Cross Blue Shield-Plan 65 Select
CIGNA PPO
HealthChoice
OSMA Health (formerly Plico PPO)
PHCS (Private Healthcare Systems)
PPO USA
Preferred Community Choice
Private Healthcare Systems (PHCS)
Railroad Medicare
United Healthcare Options PPO |
| Hospital Privileges: |
Muskogee Community Hospital
Muskogee, OK
St. Francis Hospital - Muskogee (frmly Muskogee Reg. Med. Ctr./Eastar)
Muskogee, OK
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