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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Wednesday, December 18, 2024 6:43 PM CST
Next Update: Thursday, December 19, 2024 2:50 AM CST

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JIN, MARVIN YOUNG JONG       
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.
Practice Address: 1620 E 12TH ST
TULSA OK 74120

Address last updated on 6/4/2024
Phone #: (918) 492-7722
Fax #: (918) 357-5859
County: TULSA
License: 10968
Dated: 8/12/1976
Expires: 8/1/2025
License Type: Medical Doctor
Specialty: Psychiatry
Child and Adolescent Psychiatry
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: YES
Medical School: Chonnam Univ Med Sch, Kwangju, So Korea
Graduated: 2 / 1971
CME Year: 2027
Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Certifications: AMERICAN BOARD OF PSYCHIATRY AND NEUROLOGY
New Patients: No
Medicaid: Yes
Medicare: Yes
   
HMO/PPO: Aetna HMO
Aetna PPO
Blue Cross Blue Shield-Blue Preferred
Blue Cross Blue Shield-Blue Traditional
BlueChoice PPO
Champ VA
CIGNA HMO
CIGNA PPO
HealthChoice
Heartland Health Plan of Oklahoma
PacifiCare of Oklahoma, Inc
PHCS (Private Healthcare Systems)
Preferred Community Choice
Private Healthcare Systems (PHCS)
Prudential Health Care Plan, Inc
UniCare Health Plans of Oklahoma
United Healthcare Choice
United Healthcare Options PPO
Welcor/Sooner
Hospital Privileges: Ascension St. John Medical Center
Tulsa, OK
Parkside Comm. Psychiatric Services & Hospital
Tulsa, OK
Locations: Hours: Languages:
1620 E 12TH ST
TULSA OK 74120

Phone #: (918) 492-7722
Fax #: (918) 357-5859
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
STEPHANIE MCQUARTERS APRN 72210
UCHENNA OKOLONWAMU PA 2047
DAPHNIE PEAK APRN 109779

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