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Oklahoma Board of Medical Licensure and Supervision

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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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ORTIZ, LISA DIANNE       
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: CHOCTAW NATION-IDABEL CLINIC
902 E LINCOLN RD
IDABEL OK 74745

Address last updated on 8/22/2024
Phone #: (580) 286-2600
Fax #: (580) 286-1087
County: MCCURTAIN
License: 25970
Dated: 10/1/2007
Expires: 10/1/2025
License Type: Medical Doctor
Specialty: Internal Medicine
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: NO
Medical School: Wayne State Univ SOM, Detroit Mi 48201
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 INTERNAL MEDICINE
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
CHOCTAW NATION-IDABEL CLINIC
902 E LINCOLN RD
IDABEL OK 74745

Phone #: (580) 286-2600
Fax #: (580) 286-1087
Mon: 8:00AM - 4:30PM
Tue: 8:00AM - 4:30PM
Wed: 8:00AM - 4:30PM
Thu: 8:00AM - 4:30PM
Fri: 8:00AM - 4:30PM
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
REBEL SMITH APRN 72185

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