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Next Update: Thursday, December 26, 2024 12:00 PM CST
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HENSON, EDWIN RAY 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: |
PEDIATRIC CLINIC
4301 WILSON STREET
FORT SILL OK 73503
Address last updated on 6/26/2023 |
| Phone #: |
(580) 558-3942 |
| Fax #: |
(580) 558-3408 |
| County: |
COMANCHE |
| License: |
16952 |
| Dated: |
7/1/1989 |
| Expires: |
7/1/2025 |
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Training
Issued:
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5/31/1988 |
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Training
Expires:
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9/30/1989 |
| License Type: |
Medical Doctor |
| Specialty: |
Pediatrics |
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| Status: |
Active |
| Status Class: |
Fully Licensed |
| Restricted to: |
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| Registered to Dispense: |
NO |
| Medical School: |
Eastern VA Med Sch, Norfolk, VA |
| Graduated: |
5 /
1988 |
| CME Year: |
2027 |
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Pending and/or Past Disciplinary Actions:
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| Date |
Action |
Reasons |
Remarks |
| 9/12/1999 |
Probation Ended |
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| 9/9/1994 |
Probation |
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| 9/9/1994 |
Suspension, License |
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Board Filings and/or Orders:
09/09/1994
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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 PEDIATRICS |
| New Patients: |
Yes |
| Medicaid: |
No |
| Medicare: |
No |
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| HMO/PPO: |
Tricare for Life
Tricare Standard |
| Hospital Privileges: |
Reynolds Army Community Hospital
Fort Sill, OK
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