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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Friday, November 22, 2024 6:42 PM CST
Next Update: Saturday, November 23, 2024 2:50 AM CST

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JACKSON, NEIL DAVID       
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: 5708 NW 132ND ST
OKLAHOMA CITY OK 73142

Address last updated on 5/3/2024
Phone #: (405) 949-3011
Fax #:
County: OKLAHOMA
License: 33165
Dated: 7/1/2017
Expires: 7/1/2025
License Type: Medical Doctor
Specialty: Radiology
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of Tx Med Branch Galveston, Galveston Tx 77550
Graduated: 6 / 2016
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:
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
5708 NW 132ND ST
OKLAHOMA CITY OK 73142

Phone #: (405) 949-3011
Fax #:
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
STEVEN RUSSELL O'DELL PA 1321

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