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Oklahoma Board of Medical Licensure and Supervision

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PEDEN, MONTGOMERY CHARLES       
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: 101 PROFESSIONAL LANE
ENTERPRISE AL 36330-8238

Address last updated on 6/7/2001
Phone #: (334) 347-3404 x0
Fax #: (334) 347-2500
County: NOT OKLAHOMA
License: 14416
Dated: 7/14/1983
Expires: 7/1/2007
License Type: Medical Doctor
Specialty: Internal Medicine
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 / 1982
CME Year: 2009
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 INTERNAL MEDICINE
New Patients: Yes
Medicaid: Yes
Medicare: Yes
   
HMO/PPO: United Healthcare Options PPO
Hospital Privileges: Hospital Not Listed
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Locations: Hours: Languages:
101 PROFESSIONAL LANE
ENTERPRISE AL 36330-8238

Phone #: (334) 347-3404 x0
Fax #: (334) 347-2500
Mon: 9:00AM - 7:00PM
Tue: 9:00AM - 7:00PM
Wed: 9:00AM - 7:00PM
Thu: 9:00AM - 7:00PM
Fri: 9:00AM - 5:00PM
Sat: 9:00AM - 3:00PM
Spanish

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