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NICHOLSON, CHARLES ALFRED III       
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: 3500 SE FRANK PHILLIPS BLVD.
REGIONAL MEDICAL LABORATORY
BARTLESVILLE OK 74006
Phone #: (918) 331-1712
Fax #: (918) 744-3482
County: WASHINGTON
License: 23299
Dated: 3/17/2003
Expires: 3/1/2007
License Type: Medical Doctor
Specialty: Anatomic/Clinical Pathology
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of Ok Coll Of Med, Oklahoma City Ok 73190
Graduated: 5 / 1998
CME Year: 2009
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 PATHOLOGY
New Patients: Yes
Medicaid: Yes
Medicare: Yes
   
HMO/PPO: None listed
Hospital Privileges: Ascension St. John Jane Phillips Medical Center
Bartlesville, OK
Ascension St. John Medical Center
Tulsa, OK
Hospital(s) Not In Oklahoma
,
INTEGRIS Health Ponca City Hospital -(frmly Via Christi)
Ponca City, OK
Stillwater Medical Center
Stillwater, OK
Locations: Hours: Languages:
3500 SE FRANK PHILLIPS BLVD.
REGIONAL MEDICAL LABORATORY
BARTLESVILLE OK 74006

Phone #: (918) 331-1712
Fax #: (918) 744-3482
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:

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