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Last Update: Friday, November 22, 2024 6:42 PM CST
Next Update: Saturday, November 23, 2024 2:50 AM CST
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MOORE, MAC EDWARD
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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.
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| Practice Address: |
3130 SW 89TH ST
SUITE 100
OKLAHOMA CITY OK 73159-7907
Address last updated on 4/30/2024 |
| Phone #: |
(405) 692-3737 |
| Fax #: |
(405) 692-3707 |
| County: |
CLEVELAND |
| License: |
23409 |
| Dated: |
6/20/2005 |
| Expires: |
6/1/2025 |
| License Type: |
Medical Doctor |
| Specialty: |
Orthopedic Surgery |
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| Status: |
Active |
| Status Class: |
Fully Licensed |
| Restricted to: |
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| Registered to Dispense: |
YES |
| Medical School: |
LSU Sch Of Med in Shreveport, Shreveport La 71130 |
| Graduated: |
5 /
2003 |
| CME Year: |
2025 |
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Pending and/or Past Disciplinary Actions:
No Disciplinary Action Taken.
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All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
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| Certifications: |
AMERICAN BOARD OF ORTHOPAEDIC SURGERY |
| New Patients: |
Yes |
| Medicaid: |
Yes |
| Medicare: |
Yes |
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| HMO/PPO: |
None listed |
| Hospital Privileges: |
Community Hospital - OKC
Oklahoma City, OK
Great Plains Regional Medical Center
Elk City, OK
INTEGRIS Baptist Medical Center
Oklahoma City, OK
INTEGRIS Baptist Portland Ave (fmly Deaconess Hospital)
Oklahoma City, OK
INTEGRIS Canadian Valley Regional Hospital
Yukon, OK
INTEGRIS Southwest Medical Center
Oklahoma City, OK
Norman Regional Hospital
Norman, OK
Northwest Surgical Hospital
Oklahoma City, OK
Oklahoma Spine Hospital
Oklahoma City, OK
SSM St Anthony Midwest Regional Medical Center
Midwest City, OK
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