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Next Update: Thursday, December 19, 2024 2:50 AM CST
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SAMPLE, THEODORE G
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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.
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| Practice Address: |
537 CROWN POINTE ESTATES COURT
WILDWOOD MO 63021-2012
Address last updated on 1/10/2020 |
| Phone #: |
(314) 223-9285 |
| Fax #: |
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| County: |
NOT OKLAHOMA |
| License: |
30362 |
| Dated: |
2/1/2014 |
| Expires: |
2/1/2025 |
| License Type: |
Medical Doctor |
| Specialty: |
Pediatric Critical Care Medicine
Hospitalist
Pediatrics |
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| Status: |
Active |
| Status Class: |
Fully Licensed |
| Restricted to: |
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| Registered to Dispense: |
NO |
| Medical School: |
American Univ Of The Caribbean, Sch Of Med, St Maarten, Netherlands Antille |
| Graduated: |
6 /
1985 |
| CME Year: |
2026 |
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Pending and/or Past Disciplinary Actions:
No Disciplinary Action Taken.
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All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
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| Certifications: |
AMERICAN BOARD OF PEDIATRICS |
| New Patients: |
Yes |
| Medicaid: |
Yes |
| Medicare: |
Yes |
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| HMO/PPO: |
None listed |
| Hospital Privileges: |
Ascension St. John Jane Phillips Medical Center
Bartlesville, OK
Hospital(s) Not In Oklahoma
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INTEGRIS Baptist Regional Health Ctr.
Miami, OK
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