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Last Update: Wednesday, December 18, 2024 6:43 PM CST
Next Update: Thursday, December 19, 2024 2:50 AM CST
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DAVIS, DEMETRICE
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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: |
11995 SINGLETREE LANE
STE 500
EDEN PRAIRIE MN 55344
Address last updated on 12/9/2024 |
| Phone #: |
(952) 595-1100 |
| Fax #: |
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| County: |
NOT OKLAHOMA |
| License: |
40320 |
| Dated: |
2/17/2023 |
| Expires: |
2/1/2025 |
| License Type: |
Medical Doctor |
| Specialty: |
Diagnostic Radiology |
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| Status: |
Active |
| Status Class: |
Fully Licensed |
| Restricted to: |
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| Registered to Dispense: |
NO |
| Medical School: |
Chicago Med Sch at Rosalin Franklin Univ of Med & Sci, North Chicago, IL |
| Graduated: |
6 /
2005 |
| 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 RADIOLOGY (Diagnostic Radiology specific) |
| New Patients: |
Yes |
| Medicaid: |
Yes |
| Medicare: |
Yes |
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| HMO/PPO: |
None listed |
| Hospital Privileges: |
Hospital(s) Not In Oklahoma
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Mercy Hospital Healdton (fmly Healdton Municipal)
Healdton, OK
Mercy Hospital OKC
Oklahoma City, OK
Mercy Hospital Tishomingo (fmly Johnston Memorial)
Tishomingo, OK
Mercy Memorial Health Center, Inc. - Ardmore
Ardmore, OK
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