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Next Update: Saturday, December 21, 2024 12:00 PM CST
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HICKSON, JOHNNY DERROLL III
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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: |
11000 HEFNER POINTE DR
OKLAHOMA CITY OK 73120
Address last updated on 12/4/2023 |
| Phone #: |
(405) 749-9655 |
| Fax #: |
(405) 749-1001 |
| County: |
OKLAHOMA |
| License: |
30411 |
| Dated: |
2/24/2014 |
| Expires: |
2/1/2025 |
| License Type: |
Medical Doctor |
| Specialty: |
Urology |
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| Status: |
Active |
| Status Class: |
Fully Licensed |
| Restricted to: |
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| Registered to Dispense: |
YES |
| Medical School: |
Univ Of Ok Coll Of Med, Oklahoma City Ok 73190 |
| Graduated: |
6 /
2009 |
| 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 UROLOGY |
| New Patients: |
Yes |
| Medicaid: |
No |
| Medicare: |
Yes |
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| HMO/PPO: |
Aetna HMO
Aetna PPO
Blue Cross Blue Shield-Blue Preferred
Blue Cross Blue Shield-Blue Traditional
Blue Cross Blue Shield-Plan 65 Select
BlueChoice PPO
BlueLincs HMO
Champ VA
CIGNA HMO
CIGNA PPO
CommunityCare HMO, Inc
Coventry Health Care National Network
First Health
Health Smart Preferred Care (HSPC)
HealthChoice
Humana Medicare Advantage PPO
Multiplan PPO
OSMA Health (formerly Plico PPO)
Pacificare Commercial HMO
PacifiCare of Oklahoma, Inc
PHCS (Private Healthcare Systems)
Preferred Community Choice
Private Healthcare Systems (PHCS)
Railroad Medicare
Secure Horizons HMO
Tricare for Life
United Healthcare Choice
United Healthcare Options PPO |
| Hospital Privileges: |
INTEGRIS Baptist Medical Center
Oklahoma City, OK
INTEGRIS Baptist Portland Ave (fmly Deaconess Hospital)
Oklahoma City, OK
INTEGRIS Edmond
Edmond, OK
Lakeside Women's Hospital
Oklahoma City, OK
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| Locations: |
Hours: |
Languages: |
11000 HEFNER POINTE DR
OKLAHOMA CITY OK 73120
Phone #:
(405) 749-9655
Fax #:
(405) 749-1001 |
Mon: 8:00AM - 5:00PM
Tue: 8:00AM - 5:00PM
Wed: 8:00AM - 5:00PM
Thu: 8:00AM - 5:00PM
Fri: 8:00AM - 3:00PM
Sat:
Sun: |
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