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MCGILLICUDDY, JEFFREY
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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: |
1011 14TH AVENUE NW
ARDMORE OK 73401
Address last updated on 10/15/2018 |
| Phone #: |
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| Fax #: |
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| County: |
CARTER |
| License: |
34093 |
| Dated: |
9/13/2018 |
| Expires: |
9/1/2019 |
| License Type: |
Medical Doctor |
| Specialty: |
Orthopedic Surgery
Sports Medicine (Orthopedic Surgery) |
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| Status: |
Inactive |
| Status Class: |
Expired License |
| Restricted to: |
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| Registered to Dispense: |
NO |
| Medical School: |
Stanford Univ Sch Of Med, Stanford CA 94305 |
| Graduated: |
6 /
1993 |
| CME Year: |
2021 |
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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 ORTHOPAEDIC SURGERY
AMERICAN BOARD OF ORTHOPAEDIC SURGERY - Orthopaedic Sports Medicine |
| New Patients: |
Contact licensee |
| Medicaid: |
Contact licensee |
| Medicare: |
Contact licensee |
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| HMO/PPO: |
None listed |
| Hospital Privileges: |
None listed |
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