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Last Update: Saturday, December 21, 2024 3:49 AM CST
Next Update: Saturday, December 21, 2024 12:00 PM CST
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HAMMOND, MICHAEL WAYNE
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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: |
1607 S MUSKOGEE AVE SUITE C
TAHLEQUAH OK 74464
Address last updated on 6/21/2022 |
| Phone #: |
(918) 772-5456 |
| Fax #: |
(918) 223-8400 |
| County: |
CHEROKEE |
| License: |
15215 |
| Dated: |
7/1/1985 |
| Expires: |
7/1/2025 |
| License Type: |
Medical Doctor |
| Specialty: |
Family 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 /
1984 |
| CME Year: |
2027 |
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Pending and/or Past Disciplinary Actions:
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| Date |
Action |
Reasons |
Remarks |
| 7/23/2003 |
Probation Ended |
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| 7/23/1998 |
Probation |
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| 7/23/1998 |
Suspension, License |
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Board Filings and/or Orders:
07/23/1998
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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: |
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| New Patients: |
Yes |
| Medicaid: |
Yes |
| Medicare: |
Yes |
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| HMO/PPO: |
Aetna PPO
Blue Cross Blue Shield-Blue Preferred
Blue Cross Blue Shield-Blue Traditional
BlueChoice PPO
BlueLincs HMO
CIGNA PPO
First Health
HealthChoice
OSMA Health (formerly Plico PPO)
PPO USA
Railroad Medicare
United Healthcare Options PPO |
| Hospital Privileges: |
Northeastern Health System (formerly Tahlequah City Hospital)
Tahlequah, OK
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| Locations: |
Hours: |
Languages: |
1607 S MUSKOGEE AVE SUITE C
TAHLEQUAH OK 74464
Phone #:
(918) 772-5456
Fax #:
(918) 223-8400 |
Mon: 8:30AM - 5:00PM
Tue: 8:30AM - 5:00PM
Wed: 8:30AM - 5:00PM
Thu: 8:30AM - 5:00PM
Fri: 8:30AM - 5:00PM
Sat:
Sun: 1:30AM - 0:00PM |
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Primary Supervisees(s):
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| Name: |
Type: |
License Number: |
Full/Part Time: |
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BRIAN COOKSON
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APRN |
68390 |
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