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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Wednesday, December 18, 2024 6:43 PM CST
Next Update: Thursday, December 19, 2024 2:50 AM CST

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CHAMBERS, SHANNON GOODWIN       
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.
Practice Address: 500 BROOKSIDE DRIVE
MADILL OK 73446

Address last updated on 11/9/2023
Phone #: (580) 795-5506 x1620
Fax #: (580) 795-5145
County: MARSHALL
License: 20525
Dated: 1/23/1998
Expires: 1/1/2026
License Type: Medical Doctor
Specialty: Family Medicine
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of Ok Coll Of Med, Oklahoma City Ok 73190
Graduated: 6 / 1995
CME Year: 2028
Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Certifications: AMERICAN BOARD OF FAMILY MEDICINE
New Patients: Yes
Medicaid: No
Medicare: Yes
   
HMO/PPO: Aetna PPO
BlueChoice PPO
CIGNA PPO
HealthChoice
Preferred Community Choice
United Healthcare Options PPO
Hospital Privileges: INTEGRIS Marshall Memorial Hospital
Madill, OK
Locations: Hours: Languages:
500 BROOKSIDE DRIVE
MADILL OK 73446

Phone #: (580) 795-5506 x1620
Fax #: (580) 795-5145
Mon: 8:30AM - 5:00PM
Tue: 8:30AM - 5:00PM
Wed: 8:30AM - 5:00PM
Thu: 8:30AM - 5:00PM
Fri: 8:30AM - 5:00PM
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
JASON SCOTT SQUIRES PA 1034
M. BINKLEY STAFFORD AT 15

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