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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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HAGUE, SAMUEL LYLE       
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: 1009 WEST FERGUSON
BLACKWELL OK 74631

Address last updated on 6/25/2024
Phone #: (580) 363-0052
Fax #: (580) 363-3089
County: KAY
License: 22530
Dated: 7/16/2002
Expires: 7/1/2025
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 / 2001
CME Year: 2026
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: Yes
Medicaid: Yes
Medicare: Yes
   
HMO/PPO: None listed
Hospital Privileges: Stillwater Medical Blackwell (fmly INTEGRIS Blackwell Reg. Hosp.)
Blackwell, OK
Locations: Hours: Languages:
1009 WEST FERGUSON
BLACKWELL OK 74631

Phone #: (580) 363-0052
Fax #: (580) 363-3089
Mon: 9:00AM - 5:00PM
Tue: 9:00AM - 5:00PM
Wed: 9:00AM - 5:00PM
Thu: 9:00AM - 5:00PM
Fri: 9:00AM - 12:00PM
Sat:
Sun:
2101 N 14th
Suite 114
Ponca City, OK 74601

Phone #: (580) 762-1552
Fax #: (8) 200-
Mon:
Tue:
Wed:
Thu:
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Sat:
Sun:
1909 W 6th
Suite B
Stillwater, OK 74074

Phone #: (405) 385-0029
Fax #: (2) 200-
Mon:
Tue:
Wed:
Thu:
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Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
PARNELL RAY ADAMS PA 798
ANGELA BALDRIDGE APRN 15871
BRITTANY BEIER APRN 1690
DAWN BROWN APRN 78425
KELSEY B BURNETT PA 2382
CALEB JOSIAH COUCH PA 5161
DEBRA DENISE DAVIS PA 5397
ZACKERY RYAN DEVINE PA 4394
SHANNA DOUGLASS APRN 79263
MONA MIX APRN 11090
MARY GRACE SCHURTER APRN 17358
KAREN LEIGH WEBSTER PA 1641

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