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Next Update: Thursday, December 19, 2024 12:00 PM CST
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BONILLA, MARIO ANTONIO
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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: |
1727 CHUCKWA
SUITE 400
DURANT OK 74701
Address last updated on 8/20/2012 |
| Phone #: |
(903) 465-3624 |
| Fax #: |
(903) 465-3973 |
| County: |
BRYAN |
| License: |
12480 |
| Dated: |
9/25/1979 |
| Expires: |
1/30/2021 |
| License Type: |
Medical Doctor |
| Specialty: |
Cardiovascular Disease
Internal Medicine |
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| Status: |
Inactive |
| Status Class: |
Expired License |
| Restricted to: |
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| Registered to Dispense: |
NO |
| Medical School: |
Univ De El Salvador, Fac De Med, San Salvador, El Salvador |
| Graduated: |
6 /
1971 |
| CME Year: |
2021 |
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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 INTERNAL MEDICINE
AMERICAN BOARD OF INTERNAL MEDICINE - Cardiovascular Disease |
| New Patients: |
Yes |
| Medicaid: |
Yes |
| Medicare: |
Yes |
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| HMO/PPO: |
Aetna HMO
Aetna PPO
HealthChoice
Preferred Community Choice |
| Hospital Privileges: |
Medical Center of Southeastern OK
Durant, OK
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| Locations: |
Hours: |
Languages: |
1727 CHUCKWA
SUITE 400
DURANT OK 74701
Phone #:
(903) 465-3624
Fax #:
(903) 465-3973 |
Mon: 8:00AM - 5:30PM
Tue: 8:00AM - 5:30PM
Wed: 8:00AM - 5:30PM
Thu: 8:00AM - 5:30PM
Fri: 8:00AM - 12:00PM
Sat:
Sun: |
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