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Next Update: Thursday, December 19, 2024 2:50 AM CST
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WAGNER, TIMOTHY RONALD
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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: |
330 MERCY ST
LAKE CITY SC 29560
Address last updated on 3/30/2015 |
| Phone #: |
(843) 374-5267 |
| Fax #: |
(843) 374-6243 |
| County: |
NOT OKLAHOMA |
| License: |
22305 |
| Dated: |
5/18/2001 |
| Expires: |
5/1/2016 |
| License Type: |
Medical Doctor |
| Specialty: |
Orthopedic Surgery |
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| Status: |
Inactive |
| Status Class: |
Expired License |
| Restricted to: |
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| Registered to Dispense: |
NO |
| Medical School: |
Temple Univ Sch Of Med, Philadelphia Pa 19140 |
| Graduated: |
1 /
1975 |
| CME Year: |
2016 |
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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 ORTHOPAEDIC SURGERY |
| New Patients: |
Yes |
| Medicaid: |
Yes |
| Medicare: |
Yes |
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| HMO/PPO: |
Aetna HMO
BlueChoice PPO
BlueLincs HMO
CommunityCare HMO, Inc
HealthChoice
Heartland Health Plan of Oklahoma
PacifiCare of Oklahoma, Inc
Preferred Community Choice
Prime Advantage Health Plan
Prudential Health Care Plan, Inc
UniCare Health Plans of Oklahoma
United Healthcare HMO
United Healthcare Options PPO
Welcor/Sooner |
| Hospital Privileges: |
INTEGRIS Health Ponca City Hospital -(frmly Via Christi)
Ponca City, OK
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| Locations: |
Hours: |
Languages: |
330 MERCY ST
LAKE CITY SC 29560
Phone #:
(843) 374-5267
Fax #:
(843) 374-6243 |
Mon: 9:00AM - 5:00PM
Tue: 9:00AM - 5:00PM
Wed: 9:00AM - 5:00PM
Thu: 9:00AM - 12:30PM
Fri: 9:00AM - 1:00PM
Sat:
Sun: |
Spanish |
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