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Next Update: Saturday, December 21, 2024 12:00 PM CST
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WHATLEY, JERRY DAVID
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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: |
HEALTHY IMAGE
3101 CHANDLER ROAD #105
MUSKOGEE OK 74403
Address last updated on 10/2/2023 |
| Phone #: |
(918) 400-3488 |
| Fax #: |
(918) 913-7005 |
| County: |
MUSKOGEE |
| License: |
19096 |
| Dated: |
11/17/1995 |
| Expires: |
11/1/2025 |
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Temp.
Lic.
Issued:
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6/17/1993 |
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Temp.
Lic.
Expires:
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9/1/1994 |
| License Type: |
Medical Doctor |
| Specialty: |
Adolescent Medicine (Pediatrics)
Nutrition |
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| Status: |
Active |
| Status Class: |
Fully Licensed |
| Restricted to: |
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| Registered to Dispense: |
YES |
| Medical School: |
American Univ Of The Caribbean, Sch Of Med, St Maarten, Netherlands Antille |
| Graduated: |
11 /
1992 |
| CME Year: |
2027 |
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Pending and/or Past Disciplinary Actions:
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| Date |
Action |
Reasons |
Remarks |
| 1/17/2013 |
Probation Ended |
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| 1/29/2009 |
Modification Order |
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| 1/17/2008 |
Probation |
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| 4/13/2007 |
Complaint Citation |
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Board Filings and/or Orders:
01/29/2009
04/12/2007
04/12/2007
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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: |
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| New Patients: |
Yes |
| Medicaid: |
Yes |
| Medicare: |
No |
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| HMO/PPO: |
Aetna PPO
Blue Cross Blue Shield-Blue Preferred
Blue Cross Blue Shield-Blue Traditional
BlueChoice PPO
CIGNA PPO
First Health
HealthChoice
OSMA Health (formerly Plico PPO)
Preferred Community Choice
SoonerCare HMO
SoonerCare PPO
Tricare Standard
United Healthcare Options PPO
Welcor/Sooner |
| Hospital Privileges: |
St. Francis Hospital - Muskogee (frmly Muskogee Reg. Med. Ctr./Eastar)
Muskogee, OK
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Primary Supervisees(s):
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| Name: |
Type: |
License Number: |
Full/Part Time: |
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PHYLLIS PEACE
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APRN |
79303 |
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