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Next Update: Monday, December 23, 2024 12:00 PM CST
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JACKSON, SAMANTHA LEWELLEN
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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: |
415 W FOREST LANE
HOBART OK 73651-0826
Address last updated on 8/27/2024 |
| Phone #: |
(580) 726-2226 |
| Fax #: |
(580) 726-8425 |
| County: |
KIOWA |
| License: |
19876 |
| Dated: |
7/18/1996 |
| Expires: |
7/1/2025 |
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Temp.
Lic.
Issued:
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7/6/1995 |
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Temp.
Lic.
Expires:
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8/1/1996 |
| 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: |
YES |
| Medical School: |
Univ Of Ok Coll Of Med, Oklahoma City Ok 73190 |
| Graduated: |
5 /
1995 |
| 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: |
Yes |
| Medicaid: |
Yes |
| Medicare: |
Yes |
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| HMO/PPO: |
Aetna HMO
Aetna PPO
BlueChoice PPO
BlueLincs HMO
HealthChoice
PacifiCare of Oklahoma, Inc
Prudential Health Care Plan, Inc
United Healthcare HMO
United Healthcare Options PPO
Welcor/Sooner |
| Hospital Privileges: |
Elkview General Hospital
Hobart, OK
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| Locations: |
Hours: |
Languages: |
415 W FOREST LANE
HOBART OK 73651-0826
Phone #:
(580) 726-2226
Fax #:
(580) 726-8425 |
Mon: 8:00AM - 4:30PM
Tue: 8:00AM - 4:30PM
Wed: 8:00AM - 4:30PM
Thu: 8:00AM - 4:30PM
Fri: 8:00AM - 12:00PM
Sat:
Sun: |
Spanish |
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