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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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SOUTHMAYD, LEROY 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: |
1202 W. WILSHIRE BOULEVARD
OKLAHOMA CITY OK 73116-6109
Address last updated on 12/2/2024 |
| Phone #: |
(405) 823-3073 |
| Fax #: |
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| County: |
OKLAHOMA |
| License: |
17164 |
| Dated: |
1/13/1990 |
| Expires: |
1/1/2026 |
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Temp.
Lic.
Issued:
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10/26/1989 |
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Temp.
Lic.
Expires:
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1/14/1990 |
| License Type: |
Medical Doctor |
| Specialty: |
Internal Medicine
Nephrology |
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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: |
6 /
1982 |
| CME Year: |
2028 |
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Pending and/or Past Disciplinary Actions:
No Disciplinary Action Taken.
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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 INTERNAL MEDICINE
AMERICAN BOARD OF PREVENTIVE MEDICINE - Clinical Informatics |
| New Patients: |
No |
| Medicaid: |
Yes |
| Medicare: |
Yes |
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| HMO/PPO: |
None listed |
| Hospital Privileges: |
INTEGRIS Baptist Medical Center
Oklahoma City, OK
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