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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.
Practice Address: JACK C. MONTGOMERY VA MEDICAL CENTER
1011 HONOR HEIGHTS DRIVE
MUSKOGEE OK 74401

Address last updated on 5/21/2020
Phone #: (918) 577-3000 x3657
Fax #: (918) 577-3975
County: MUSKOGEE
License: 21163
Dated: 6/25/1999
Expires: 6/1/2021
License Type: Medical Doctor
Specialty: Internal Medicine
Hematology (Internal Medicine)
Medical Oncology
Status: Inactive
Status Class: Physician Emeritus
Restricted to:
Registered to Dispense: NO
Medical School: M P Shah Med Coll, Saurashtra Univ, Jamnagar, Gujarat, India
Graduated: 11 / 1979
CME Year: 2023
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:
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
JACK C. MONTGOMERY VA MEDICAL CENTER
1011 HONOR HEIGHTS DRIVE
MUSKOGEE OK 74401

Phone #: (918) 577-3000 x3657
Fax #: (918) 577-3975
Mon:
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