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DAVIS, NICHOLAS JOHN       
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: 72ND MDOS
7050 AIR DEPOT BLVD
BLDG 1094
TINKER AFB OK 73145

Address last updated on 5/24/2016
Phone #: (405) 582-6488
Fax #:
County: OKLAHOMA
License: 29356
Dated: 7/30/2012
Expires: 7/1/2017
License Type: Medical Doctor
Specialty: General Surgery
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: Med Coll Of Wi, Milwaukee Wi 53226
Graduated: 5 / 2007
CME Year: 2018
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 SURGERY
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: INTEGRIS Edmond
Edmond, OK
OU Health Medical Center
Oklahoma City, OK
SSM St Anthony Midwest Regional Medical Center
Midwest City, OK
Locations: Hours: Languages:
72ND MDOS
7050 AIR DEPOT BLVD
BLDG 1094
TINKER AFB OK 73145

Phone #: (405) 582-6488
Fax #:
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:

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