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MCCOLLOM, THERESA LYNNE       
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: OBSTETRIX MEDICAL GROUP OF PHOENIX
4722 N. 24TH ST SUITE 100
PHOENIX AZ 85016

Address last updated on 5/3/2024
Phone #: (480) 613-7652 x254
Fax #: (480) 613-7652
County: NOT OKLAHOMA
License: 24125
Dated: 7/23/2004
Expires: 7/1/2025
Temp. Lic. Issued: 7/1/2004
Temp. Lic. Expires: 7/31/2004
License Type: Medical Doctor
Specialty: Obstetrics & Gynecology
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: YES
Medical School: Univ Of Ok Coll Of Med, Oklahoma City Ok 73190
Graduated: 6 / 2001
CME Year: 2025
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 OBSTETRICS AND GYNECOLOGY
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: Hospital(s) Not In Oklahoma
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Locations: Hours: Languages:
OBSTETRIX MEDICAL GROUP OF PHOENIX
4722 N. 24TH ST SUITE 100
PHOENIX AZ 85016

Phone #: (480) 613-7652 x254
Fax #: (480) 613-7652
Mon:
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