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Last Update: Saturday, December 21, 2024 3:49 AM CST
Next Update: Saturday, December 21, 2024 12:00 PM CST
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TINGLEAF, CLARK JIRO
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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: |
10512 NORTH 110TH EAST AVENUE
OWASSO OK 74055-6636
Address last updated on 5/27/2024 |
| Phone #: |
(918) 376-8926 |
| Fax #: |
(918) 376-8936 |
| County: |
TULSA |
| License: |
23509 |
| Dated: |
6/20/2003 |
| Expires: |
6/1/2025 |
| License Type: |
Medical Doctor |
| Specialty: |
Urology |
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| Status: |
Active |
| Status Class: |
Fully Licensed |
| Restricted to: |
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| Registered to Dispense: |
NO |
| Medical School: |
Univ of TX at San Antonio, UTSA Long School of Medicine |
| Graduated: |
5 /
1995 |
| CME Year: |
2027 |
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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 UROLOGY |
| New Patients: |
Yes |
| Medicaid: |
Yes |
| Medicare: |
Yes |
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| HMO/PPO: |
Aetna HMO
Aetna PPO
BlueChoice PPO
BlueLincs HMO
CIGNA HMO
CIGNA PPO
CommunityCare HMO, Inc
HealthChoice
HealthChoice
OSMA Health (formerly Plico PPO)
PacifiCare of Oklahoma, Inc
Preferred Community Choice
Prudential Health Care Plan, Inc
UniCare Health Plans of Oklahoma
United Healthcare HMO
United Healthcare Options PPO
Welcor/Sooner |
| Hospital Privileges: |
Baily Medical Center
Owasso, OK
Hillcrest Hospital South
Tulsa, OK
Hillcrest Medical Center
Tulsa, OK
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