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Next Update: Thursday, December 19, 2024 2:50 AM CST
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DAVIDSON, RUSSELL ALLEN
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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: |
905 C TORTOISE DRIVE
LAWTON OK 73507
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| Phone #: |
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| Fax #: |
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| County: |
COMANCHE |
| License: |
20055 |
| Dated: |
1/13/1997 |
| Expires: |
1/1/1999 |
| License Type: |
Medical Doctor |
| Specialty: |
General Surgery |
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| Status: |
Inactive |
| Status Class: |
Expired License |
| Restricted to: |
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| Registered to Dispense: |
NO |
| Medical School: |
Med Univ Of SC Coll Of Med, Charleston Sc 29425 |
| Graduated: |
5 /
1995 |
| CME Year: |
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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: |
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| 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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