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JACKSON, DOROTHY LOUISE       
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: HERITAGE PARK MED CTR
6908 E RENO
MIDWEST CITY OK 73110-2128

Address last updated on 7/29/2008
Phone #: (405) 737-6871
Fax #: (405) 733-4290
County: OKLAHOMA
License: 22915
Dated: 8/7/2002
Expires: 8/1/2009
License Type: Medical Doctor
Specialty: Family Medicine
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: YES
Medical School: USUHS F E Hebert Sch of Med Bethesda Md 20814
Graduated: 5 / 1987
CME Year: 2011
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 FAMILY MEDICINE
New Patients: Yes
Medicaid: Yes
Medicare: Yes
   
HMO/PPO: Aetna HMO
Aetna PPO
BlueChoice PPO
BlueLincs HMO
CommunityCare HMO, Inc
Global Health HMO
HealthChoice
Humana Tricare/PGBA
PacifiCare of Oklahoma, Inc
Railroad Medicare
Secure Horizons HMO
SoonerCare HMO
Tricare for Life
Tricare Standard
United Healthcare HMO
United Healthcare Options PPO
Hospital Privileges: SSM Health St. Anthony Hospital - OKC
Oklahoma City, OK
SSM St Anthony Midwest Regional Medical Center
Midwest City, OK
Locations: Hours: Languages:
HERITAGE PARK MED CTR
6908 E RENO
MIDWEST CITY OK 73110-2128

Phone #: (405) 737-6871
Fax #: (405) 733-4290
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:
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