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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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CHILDS, CLINTON ROSS
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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: |
13720 E 86TH ST N
SUITE 140
OWASSO OK 74055
Address last updated on 11/4/2024 |
| Phone #: |
(918) 274-9300 |
| Fax #: |
(918) 376-2271 |
| County: |
TULSA |
| License: |
19517 |
| Dated: |
8/24/1995 |
| Expires: |
8/1/2025 |
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Training
Issued:
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6/23/1994 |
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Training
Expires:
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6/1/1996 |
| License Type: |
Medical Doctor |
| Specialty: |
Family 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 Tx Med Branch Galveston, Galveston Tx 77550 |
| Graduated: |
5 /
1994 |
| 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 FAMILY MEDICINE |
| New Patients: |
Contact licensee |
| Medicaid: |
Contact licensee |
| Medicare: |
Contact licensee |
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| HMO/PPO: |
None listed |
| Hospital Privileges: |
None listed |
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| Locations: |
Hours: |
Languages: |
13720 E 86TH ST N
SUITE 140
OWASSO OK 74055
Phone #:
(918) 274-9300
Fax #:
(918) 376-2271 |
Mon: 8:00AM - 4:30PM
Tue: 8:00AM - 4:30PM
Wed: 8:00AM - 4:30PM
Thu: 8:00AM - 4:30PM
Fri: 8:00AM - 4:30PM
Sat: CLOSED
Sun: CLOSED |
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Primary Supervisees(s):
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| Name: |
Type: |
License Number: |
Full/Part Time: |
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CARLEEN CARLISLE
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APRN |
76525 |
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