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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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HALL, THOMAS CARL       
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: 1212 W 12TH AVE.
STILLWATER OK 74074

Address last updated on 6/27/2024
Phone #: (405) 533-3376
Fax #: (405) 533-1312
County: PAYNE
License: 22869
Dated: 7/1/2003
Expires: 7/1/2025
License Type: Medical Doctor
Specialty: Dermatology
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: YES
Medical School: Univ Of Ok Coll Of Med, Oklahoma City Ok 73190
Graduated: 6 / 2002
CME Year: 2027
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 DERMATOLOGY
New Patients: Yes
Medicaid: No
Medicare: Yes
   
HMO/PPO: None listed
Hospital Privileges: Stillwater Medical Center
Stillwater, OK
Locations: Hours: Languages:
1212 W 12TH AVE.
STILLWATER OK 74074

Phone #: (405) 533-3376
Fax #: (405) 533-1312
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915 E Owen K Garriott Rd
Suite D
Enid, OK 73701

Phone #: (580) 599-0648
Fax #: (7) 202-
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916 19th St
Woodward, OK 73801

Phone #: (580) 448-0801
Fax #: (6) 202-
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415 Fairview Ave.
Suite 202
Ponca City, OK 74601

Phone #: (580) 576-3369
Fax #: (5) 202-
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Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
KENDA GALE BAKER PA 635
SHANNON WHITNEY CLARK PA 4606
DEANNA JOHNSTON CUMMINGS PA 917
ERIN PAIGE KRUCKENBERG PA 2828

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