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Oklahoma Board of Medical Licensure and Supervision

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HILLSHAFER, DAVID HURST       
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: HOMEDOC.ORG AIS OF SECURITY CAPITAL MANAGEMENT
277 S WASHINGTON ST; STE 340; ALEXANDRIA VA 22314
P.O.BOX 101; 10 DOVE TREE RD.
WEWOKA OK 74884-0101

Address last updated on 4/26/2018
Phone #: (405) 683-5002
Fax #:
County: SEMINOLE
License: 14165
Dated: 5/20/1983
Expires: 5/1/2023
License Type: Medical Doctor
Specialty: General Practice
Family Medicine
Legal Medicine
Psychiatry
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of Ok Coll Of Med, Oklahoma City Ok 73190
Graduated: 6 / 1981
CME Year: 2025
Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.
Board Filings and/or Orders:
05/13/1995
03/24/1995
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Certifications:
New Patients: No
Medicaid: No
Medicare: No
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
HOMEDOC.ORG AIS OF SECURITY CAPITAL MANAGEMENT
277 S WASHINGTON ST; STE 340; ALEXANDRIA VA 22314
P.O.BOX 101; 10 DOVE TREE RD.
WEWOKA OK 74884-0101

Phone #: (405) 683-5002
Fax #:
Mon: BY PHONE APPOINTMENT ONLY
Tue: BY PHONE APPOINTMENT ONLY
Wed: BY PHONE APPOINTMENT ONLY
Thu: BY PHONE APPOINTMENT ONLY
Fri: BY PHONE APPOINTMENT ONLY
Sat: BY PHONE APPOINTMENT ONLY
Sun: 12:00PM - 6:00PM BY PHONE APPOINTMENT ONLY
10 Dove Tree Road
Wewoka, OK 74884

Phone #: (405) 683-8153
Fax #: (1) 201-
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:

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