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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Wednesday, December 25, 2024 3:48 AM CST
Next Update: Wednesday, December 25, 2024 12:00 PM CST

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IVINS, DOUGLAS JOHN       
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: ERNEST CHILDER VA OUTPATIENT CLINIC
8921 SOUTH MINGO ROAD
TULSA OK 74133

Address last updated on 8/21/2024
Phone #: (918) 252-8000
Fax #:
County: TULSA
License: 23164
Dated: 10/28/2002
Expires: 10/1/2025
Temp. Lic. Issued: 9/26/2002
Temp. Lic. Expires: 11/24/2002
License Type: Medical Doctor
Specialty: Family Medicine
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: NO
Medical School: Rutgers Robt W Johnson Med Sch, (fmly UMDNJ)
Graduated: 5 / 1995
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: AMERICAN BOARD OF FAMILY MEDICINE
AMERICAN BOARD OF PREVENTIVE MEDICINE - Clinical Informatics
New Patients: Yes
Medicaid: Yes
Medicare: Yes
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
ERNEST CHILDER VA OUTPATIENT CLINIC
8921 SOUTH MINGO ROAD
TULSA OK 74133

Phone #: (918) 252-8000
Fax #:
Mon: 8:00AM - 4:30PM
Tue: 8:00AM - 4:30PM
Wed: 8:00AM - 4:30PM
Thu: 8:00AM - 4:30PM
Fri: 8:00AM - 4:30PM
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
AUTUMN RENAE ACKERMAN PA 1529
SHANNON DENISE IJAMS PA 906

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