LANDIS, DEREK TODD - Licensee Information

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Last Update: Tuesday, November 5, 2024 1:51 PM CST
Next Update: Tuesday, November 5, 2024 4:30 PM CST

LANDIS, DEREK TODD

Practice Address:	MERCY KIDS ARDMORE 731 NW 12TH SUITE 104 ARDMORE OK 73401 Address last updated on 6/3/2024
Phone #:	(580) 223-5311
Fax #:	(580) 223-8227
County:	CARTER
License:	25666
Dated:	7/1/2007
Expires:	7/1/2025
License Type:	Medical Doctor
Specialty:	Pediatrics

Status:	Active
Status Class:	Fully Licensed
Restricted to:
Registered to Dispense:	YES
Medical School:	U of Miami L M Miller, SOM, Miami, FL 33101
Graduated:	5 / 2004
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 PEDIATRICS
New Patients:	Yes
Medicaid:	Yes
Medicare:	Contact licensee

HMO/PPO:	None listed
Hospital Privileges:	Mercy Memorial Health Center, Inc. - Ardmore Ardmore, OK

Locations:	Hours:	Languages:
MERCY KIDS ARDMORE 731 NW 12TH SUITE 104 ARDMORE OK 73401 Phone #: (580) 223-5311 Fax #: (580) 223-8227	Mon: 8:00AM - 5:00PM Tue: 7:00AM - 5:00PM Wed: 8:00AM - 5:00PM Thu: 7:00AM - 5:00PM Fri: 8:00AM - 5:00PM Sat: Sun:

Name:	Type:	License Number:
Primary Supervisees(s):
JERRI LYNN BRADSHAW	PA	1402
SCOTT ALLEN COOPER	PA	2044