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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Friday, December 20, 2024 6:44 PM CST
Next Update: Saturday, December 21, 2024 2:50 AM CST

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GOODWIN, AUDREY BLALOCK       
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: 4629 NW 23RD STREET
OKLAHOMA CITY OK 73127-2103

Address last updated on 5/29/2024
Phone #: (405) 251-8880
Fax #: (405) 665-7024
County: OKLAHOMA
License: 29248
Dated: 7/1/2014
Expires: 7/1/2025
License Type: Medical Doctor
Specialty: MEDICINE/PEDIATRICS
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of Ok Coll Of Med, Oklahoma City Ok 73190
Graduated: 5 / 2012
CME Year: 2026
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
AMERICAN BOARD OF PEDIATRICS
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: INTEGRIS Edmond
Edmond, OK
Locations: Hours: Languages:
4629 NW 23RD STREET
OKLAHOMA CITY OK 73127-2103

Phone #: (405) 251-8880
Fax #: (405) 665-7024
Mon: 8:00AM - 5:00PM
Tue: 8:00AM - 5:00PM
Wed: 8:00AM - 5:00PM
Thu: 8:00AM - 5:00PM
Fri: 8:00AM - 5:00PM
Sat:
Sun:

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