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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Thursday, December 19, 2024 3:44 AM CST
Next Update: Thursday, December 19, 2024 12:00 PM CST

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RUTLEDGE, THEODORE MARK       
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: CHICKASAW NATION MEDICAL CENTER
1921 STONECIPHER DRIVE
ADA OK 84790-2579

Address last updated on 3/10/2024
Phone #: (580) 436-3980
Fax #: (580) 421-4552
County: PONTOTOC
License: 33535
Dated: 4/10/2018
Expires: 4/1/2025
License Type: Medical Doctor
Specialty: Internal Medicine
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: NO
Medical School: Wright St Univ Boonshoft SOM, Dayton OH
Graduated: 6 / 1991
CME Year: 2027
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:
CHICKASAW NATION MEDICAL CENTER
1921 STONECIPHER DRIVE
ADA OK 84790-2579

Phone #: (580) 436-3980
Fax #: (580) 421-4552
Mon: 8:00AM - 5:00PM
Tue: 8:00AM - 5:00PM
Wed: 8:00AM - 5:00PM
Thu: 8:00AM - 5:00AM
Fri: 8:00AM - 5:00PM
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
STEPHANIE DAWN LEU PA 1098
DEBRA SAPPENFIELD APRN 15897

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