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Last Update: Wednesday, December 18, 2024 6:43 PM CST
Next Update: Thursday, December 19, 2024 2:50 AM CST
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JOHNSON, PAUL DAVIS
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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: |
GATEWAY
1010 E 45TH STREET
SHAWNEE OK 74804
Address last updated on 4/3/2024 |
| Phone #: |
(405) 273-1170 |
| Fax #: |
(405) 275-5132 |
| County: |
OKLAHOMA |
| License: |
14767 |
| Dated: |
6/30/1984 |
| Expires: |
6/1/2025 |
| License Type: |
Medical Doctor |
| Specialty: |
Family Medicine
Addiction Medicine |
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| Status: |
Active |
| Status Class: |
Fully Licensed |
| Restricted to: |
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| Registered to Dispense: |
NO |
| Medical School: |
Univ Of Ok Coll Of Med, Oklahoma City Ok 73190 |
| Graduated: |
6 /
1983 |
| CME Year: |
2025 |
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Pending and/or Past Disciplinary Actions:
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| Date |
Action |
Reasons |
Remarks |
| 11/30/1998 |
Probation Ended |
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| 1/5/1995 |
Probation |
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| 9/9/1994 |
Surrendered License |
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Board Filings and/or Orders:
11/12/1998
01/05/1995
07/07/1994
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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 FAMILY MEDICINE |
| New Patients: |
Contact licensee |
| Medicaid: |
Contact licensee |
| Medicare: |
Contact licensee |
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| HMO/PPO: |
None listed |
| Hospital Privileges: |
OU Health Medical Center
Oklahoma City, OK
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Primary Supervisees(s):
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| Name: |
Type: |
License Number: |
Full/Part Time: |
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ANGELA AMPARANO
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APRN |
63717 |
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