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ALLEN, DERRICK ROSS       
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: 402 FLANDERS DRIVE
CHICKASHA OK 73108
Phone #:
Fax #:
County: GRADY
License: 21198
Dated: 7/7/1999
Expires: 7/1/2000
Training Issued: 7/1/1998
Training Expires: 8/1/1999
License Type: Medical Doctor
Specialty: Internal Medicine
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of Ok Coll Of Med, Oklahoma City Ok 73190
Graduated: 5 / 1998
CME Year: 2002
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:
402 FLANDERS DRIVE
CHICKASHA OK 73108

Phone #:
Fax #:

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