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Last Update: Sunday, December 22, 2024 6:44 PM CST
Next Update: Monday, December 23, 2024 2:50 AM CST

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MCCOLLOM, VANCE EDMOND       
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.
Practice Address: 3300 NW EXPRESSWAY
2ND FLOOR NEURO AND INTERVENTIONAL RADIOLOGY
OKLAHOMA CITY OK 73112-4418

Address last updated on 12/2/2024
Phone #: (405) 949-3417
Fax #: (405) 552-5165
County: OKLAHOMA
License: 17658
Dated: 7/1/1991
Expires: 7/1/2025
Training Issued: 8/16/1990
Training Expires: 9/1/1991
License Type: Medical Doctor
Specialty: Radiology
Endovascular Surgical Neuroradiology
Vascular and Interventional Radiology
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of Ok Coll Of Med, Oklahoma City Ok 73190
Graduated: 5 / 1990
CME Year: 2027
Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Certifications: AMERICAN BOARD OF RADIOLOGY
AMERICAN BOARD OF RADIOLOGY - Vascular & Interventional Radiology
AMERICAN BOARD OF RADIOLOGY (Interventional & Diagnostic specific)
New Patients: Yes
Medicaid: Yes
Medicare: Yes
   
HMO/PPO: Aetna HMO
Aetna PPO
BlueChoice PPO
BlueLincs HMO
HealthChoice
Preferred Community Choice
UniCare Health Plans of Oklahoma
United Healthcare HMO
United Healthcare Options PPO
Hospital Privileges: INTEGRIS Baptist Medical Center
Oklahoma City, OK
Locations: Hours: Languages:
3300 NW EXPRESSWAY
2ND FLOOR NEURO AND INTERVENTIONAL RADIOLOGY
OKLAHOMA CITY OK 73112-4418

Phone #: (405) 949-3417
Fax #: (405) 552-5165
Mon: 8:00AM - 5:00PM
Tue: 8:00AM - 5:00PM
Wed: 8:00AM - 5:00PM
Thu: 8:00AM - 5:00PM
Fri: 8:00AM - 5:00PM
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
JESSICA MARIE ACOSTA PA 2934
ROGER DIXON HELLWEGE PA 1230
MARGARET LORIMOR APRN 84764
JILL LEANN MILLER PA 2101
STEVEN RUSSELL O'DELL PA 1321
LAURIE NICOLE TODD PA 2016
SUSAN DORINDA WORSHAM PA 719

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