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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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ELGIN, DONALD MONROE       
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: FORT GIBSON MEDICAL CLINIC
104 LONE OAK CIRCLE
FORT GIBSON OK 74434-5001

Address last updated on 5/14/2023
Phone #: (918) 478-2101
Fax #: (918) 478-6008
County: MUSKOGEE
License: 11727
Dated: 6/1/1978
Expires: 6/1/2025
License Type: Medical Doctor
Specialty: Family Medicine
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of Ok Coll Of Med, Oklahoma City Ok 73190
Graduated: 6 / 1976
CME Year: 2025
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 FAMILY MEDICINE
New Patients: Yes
Medicaid: No
Medicare: Yes
   
HMO/PPO: None listed
Hospital Privileges: Northeastern Health System (formerly Tahlequah City Hospital)
Tahlequah, OK
St. Francis Hospital - Muskogee (frmly Muskogee Reg. Med. Ctr./Eastar)
Muskogee, OK
Locations: Hours: Languages:
FORT GIBSON MEDICAL CLINIC
104 LONE OAK CIRCLE
FORT GIBSON OK 74434-5001

Phone #: (918) 478-2101
Fax #: (918) 478-6008
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
VANESSA DICUS APRN 1415
SUSAN MILLER APRN 115364
LISA RENFROW APRN 80011

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