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Oklahoma Board of Medical Licensure and Supervision

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Next Update: Thursday, December 19, 2024 12:00 PM CST

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SMITH, NICOLE AUTUMN       
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: LEE PHYSICIAN GROUP
260 BETH STACEY BLVD
SUITE C
LEHIGH ACRES FL 33936

Address last updated on 3/16/2020
Phone #: (239) 343-9888
Fax #: (239) 343-9886
County: NOT OKLAHOMA
License: 24093
Dated: 7/1/2006
Expires: 1/30/2021
License Type: Medical Doctor
Specialty: Pediatrics
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: St Matthew's Univ-Grand Cayman
Graduated: 5 / 2004
CME Year: 2021
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 PEDIATRICS
New Patients: Yes
Medicaid: Yes
Medicare: Contact licensee
   
HMO/PPO: Blue Cross Blue Shield-Blue Preferred
Blue Cross Blue Shield-Blue Traditional
Blue Cross Blue Shield-Plan 65 Select
BlueChoice PPO
SoonerCare HMO
Hospital Privileges: None listed
Locations: Hours: Languages:
LEE PHYSICIAN GROUP
260 BETH STACEY BLVD
SUITE C
LEHIGH ACRES FL 33936

Phone #: (239) 343-9888
Fax #: (239) 343-9886
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:
3354 East 51st
Tulsa, OK 74135

Phone #: (918) 928-7828
Fax #: (9) 201-
Mon: 12:00PM - 12:00AM
Tue: 12:00PM - 12:00AM
Wed: 12:00PM - 12:00AM
Thu: 12:00PM - 12:00AM
Fri: 12:00PM - 12:00AM
Sat: 12:00PM - 12:00AM
Sun: 12:00PM - 12:00AM

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