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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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HADDAD, PHILLIP ANTHONY
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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: |
SHAWNEE MEDICAL CENTER CLINIC
3315 KETHLEY ROAD
SHAWNEE OK 74804-9638
Address last updated on 5/2/2024 |
| Phone #: |
(405) 273-5801 |
| Fax #: |
(405) 878-3805 |
| County: |
POTTAWATOMIE |
| License: |
17395 |
| Dated: |
7/19/1990 |
| Expires: |
7/1/2025 |
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Training
Issued:
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6/8/1989 |
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Training
Expires:
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9/30/1990 |
| License Type: |
Medical Doctor |
| Specialty: |
Pulmonary Disease
Critical Care Medicine (Internal Medicine)
Internal 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: |
5 /
1989 |
| CME Year: |
2027 |
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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 - Pulmonary Disease |
| New Patients: |
Contact licensee |
| Medicaid: |
Contact licensee |
| Medicare: |
Contact licensee |
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| HMO/PPO: |
None listed |
| Hospital Privileges: |
SSM Health St. Anthony Shawnee Hospital (fmly Unity Health Ctr)
Shawnee, OK
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Primary Supervisees(s):
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| Name: |
Type: |
License Number: |
Full/Part Time: |
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MARK LEROY DAVIS
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PA |
801 |
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