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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Monday, December 23, 2024 1:13 PM CST
Next Update: Monday, December 23, 2024 4:30 PM CST

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DAVIS, WILSON LLOYD JR.       
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: FAMILY HEALTH CLINIC OF SOUTHERN OKLAHOMA
610 E. 24TH STREET
TISHOMINGO OK 76034

Address last updated on 12/7/2024
Phone #: (580) 371-2343 x3368
Fax #: (580) 371-3170
County: JOHNSTON
License: 34304
Dated: 1/10/2019
Expires: 1/1/2026
Temp. Lic. Issued: 11/1/2018
Temp. Lic. Expires: 1/17/2019
License Type: Medical Doctor
Specialty: Internal Medicine
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: NO
Medical School: Univ of IA Roy J & L Carver COM, Iowa City, IA 52242
Graduated: 5 / 1978
CME Year: 2028
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: AMERICAN BOARD OF INTERNAL MEDICINE
New Patients: Yes
Medicaid: Yes
Medicare: Yes
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
FAMILY HEALTH CLINIC OF SOUTHERN OKLAHOMA
610 E. 24TH STREET
TISHOMINGO OK 76034

Phone #: (580) 371-2343 x3368
Fax #: (580) 371-3170
Mon: 7:30AM - 6:00PM
Tue: 7:30AM - 6:00PM
Wed: 7:30AM - 6:00PM
Thu: 7:30AM - 6:00PM
Fri:
Sat:
Sun: 7:30AM - 6:00PM
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
RELINDA BLACK APRN 96629
LARRY LEON BURNS PA 2416
TASHA CUMMINS APRN 109316
RALPH TILLMAN FALCONER PA 670
JESSICA PICKENS APRN 96230
HEATHER WORKMAN APRN 76690

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