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Oklahoma Board of Medical Licensure and Supervision

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DAVIS, JONATHAN LOCKWOOD       
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: 4221 SOUTH WESTERN #3010
OKLAHOMA CITY OK 73109-3492

Address last updated on 4/2/2015
Phone #: (405) 644-6232
Fax #: (405) 644-5493
County: OKLAHOMA
License: 14691
Dated: 6/11/1984
Expires: 6/1/2015
License Type: Medical Doctor
Specialty: Endocrinology, Diabetes and Metabolism
Diabetes
Internal Medicine
Status: Inactive
Status Class: Physician Emeritus
Restricted to:
Registered to Dispense: NO
Medical School: ST LOUIS UNIV SCH OF MED, ST LOUIS MO 63104
Graduated: 6 / 1970
CME Year: 2016
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 - Endocrinology, Diabetes and Metabolism
New Patients: Yes
Medicaid: No
Medicare: Yes
   
HMO/PPO: Aetna HMO
Aetna PPO
Blue Cross Blue Shield-Blue Preferred
Blue Cross Blue Shield-Blue Traditional
Blue Cross Blue Shield-Plan 65 Select
BlueChoice PPO
BlueLincs HMO
CommunityCare HMO, Inc
Global Health HMO
HealthChoice
Humana Medicare Advantage PPO
Humana Tricare/PGBA
Oklahoma Health Network PPO
OSMA Health (formerly Plico PPO)
Pacificare Commercial HMO
PacifiCare of Oklahoma, Inc
Preferred Community Choice
Railroad Medicare
Secure Horizons HMO
Tricare for Life
Tricare Standard
United Healthcare Choice
United Healthcare HMO
United Healthcare Options PPO
Hospital Privileges: INTEGRIS Southwest Medical Center
Oklahoma City, OK
Locations: Hours: Languages:
4221 SOUTH WESTERN #3010
OKLAHOMA CITY OK 73109-3492

Phone #: (405) 644-6232
Fax #: (405) 644-5493
Mon:
Tue: 9:30AM - 5:00PM
Wed: 9:30AM - 5:00PM
Thu: 9:30AM - 5:00PM
Fri:
Sat:
Sun:
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