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Last Update: Thursday, December 19, 2024 3:44 AM CST
Next Update: Thursday, December 19, 2024 12:00 PM CST
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MCLEOD, WALLACE BEVERLY III
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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: |
2216 M L KING BLVD #D
OKLAHOMA CITY OK 73111-2436
Address last updated on 8/22/2024 |
| Phone #: |
(405) 424-0111 |
| Fax #: |
(405) 424-0115 |
| County: |
OKLAHOMA |
| License: |
15393 |
| Dated: |
9/9/1985 |
| Expires: |
9/1/2025 |
| 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 /
1979 |
| CME Year: |
2027 |
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Pending and/or Past Disciplinary Actions:
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| Date |
Action |
Reasons |
Remarks |
| 5/12/2024 |
Voluntary Submittal to Jurisdiction Ended |
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| 5/12/2022 |
Voluntary Submittal to Jurisdiction |
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| 1/25/2022 |
Complaint Citation |
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Board Filings and/or Orders:
05/12/2022
01/25/2022
01/25/2022
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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: |
ABPS - 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
SSM Health St. Anthony Hospital - OKC
Oklahoma City, OK
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