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Next Update: Monday, December 23, 2024 12:00 PM CST
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WICKERSHAM, ELIZABETH ALICE
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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: |
1000 N LEE
OKLAHOMA CITY OK 73102
Address last updated on 6/25/2024 |
| Phone #: |
(405) 272-6406 |
| Fax #: |
(405) 772-4430 |
| County: |
OKLAHOMA |
| License: |
20273 |
| Dated: |
7/10/1997 |
| Expires: |
7/1/2025 |
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Training
Issued:
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7/1/1996 |
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Training
Expires:
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8/1/1997 |
| License Type: |
Medical Doctor |
| Specialty: |
Family Medicine
Palliative 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 Ok Coll Of Med, Oklahoma City Ok 73190 |
| Graduated: |
6 /
1996 |
| 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
AMERICAN BOARD OF FAMILY MEDICINE - Hospice and Palliative Medicine |
| New Patients: |
No |
| Medicaid: |
Yes |
| Medicare: |
Yes |
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| HMO/PPO: |
Aetna Elect Choice
Aetna HMO
Aetna Managed Choice
Aetna PPO
Beechstreet PPO
Blue Cross Blue Shield-Blue Preferred
Blue Cross Blue Shield-Blue Traditional
Blue Cross Blue Shield-Plan 65 Select
BlueChoice PPO
BlueLincs HMO
CommunityCare HMO, Inc
First Health
Great West Healthcare
HealthChoice
OSMA Health (formerly Plico PPO)
Pacificare Commercial HMO
PacifiCare of Oklahoma, Inc
PHCS (Private Healthcare Systems)
Physicians Direct Network
PPO USA
Preferred Community Choice
Private Healthcare Systems (PHCS)
Railroad Medicare
Secure Horizons HMO
Tricare for Life
Tricare Standard
United Healthcare Choice
United Healthcare EPO
United Healthcare HMO
United Healthcare Options PPO
United Healthcare POS |
| Hospital Privileges: |
INTEGRIS Baptist Medical Center
Oklahoma City, OK
Jackson County Memorial Hospital
Altus, OK
SSM Health St. Anthony Hospital - OKC
Oklahoma City, OK
SSM Health St. Anthony Shawnee Hospital (fmly Unity Health Ctr)
Shawnee, OK
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