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Next Update: Thursday, December 19, 2024 2:50 AM CST
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CLARK, KEITH FREDRICK
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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: |
535 NW 9TH ST
SUITE 300
OKLAHOMA CITY OK 73102
Address last updated on 5/30/2023 |
| Phone #: |
(405) 272-6027 |
| Fax #: |
(405) 272-8315 |
| County: |
OKLAHOMA |
| License: |
14220 |
| Dated: |
6/1/1983 |
| Expires: |
6/1/2025 |
| License Type: |
Medical Doctor |
| Specialty: |
Otolaryngology |
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| Status: |
Active |
| Status Class: |
Fully Licensed |
| Restricted to: |
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| Registered to Dispense: |
YES |
| Medical School: |
Univ Of Mi Med Sch, Ann Arbor Mi 48109 |
| Graduated: |
5 /
1978 |
| CME Year: |
2025 |
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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 OTOLARYNGOLOGY |
| New Patients: |
Yes |
| Medicaid: |
Yes |
| Medicare: |
Yes |
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| HMO/PPO: |
Aetna HMO
Aetna PPO
Beechstreet PPO
Blue Cross Blue Shield-Blue Traditional
Blue Cross Blue Shield-Plan 65 Select
BlueChoice PPO
BlueLincs HMO
CIGNA HMO
CIGNA PPO
CommunityCare HMO, Inc
First Health
Great West Healthcare
HealthChoice
OSMA Health (formerly Plico PPO)
PacifiCare of Oklahoma, Inc
PHCS (Private Healthcare Systems)
Preferred Community Choice
Private Healthcare Systems (PHCS)
Railroad Medicare
Secure Horizons HMO
United Healthcare EPO
United Healthcare HMO
United Healthcare Options PPO
United Healthcare POS |
| Hospital Privileges: |
SSM Health St. Anthony Hospital - OKC
Oklahoma City, OK
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