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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Monday, December 23, 2024 3:49 AM CST
Next Update: Monday, December 23, 2024 12:00 PM CST

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JOHNSON, JEFFERY CHAD       
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: 3433 NW 56TH ST STE 760
OKLAHOMA CITY OK 73112-4059

Address last updated on 8/31/2024
Phone #:
Fax #:
County: OKLAHOMA
License: 41736
Dated: 10/25/2023
Expires: 10/1/2025
License Type: Medical Doctor
Specialty: Cardiothoracic Surgery
General Surgery
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: NO
Medical School: Univ of TX Med Sch at Houston, Houston Tx 77225
Graduated: 6 / 2001
CME Year: 2026
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 SURGERY
AMERICAN BOARD OF THORACIC SURGERY
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: INTEGRIS Baptist Medical Center
Oklahoma City, OK
INTEGRIS Southwest Medical Center
Oklahoma City, OK
Locations: Hours: Languages:
3433 NW 56TH ST STE 760
OKLAHOMA CITY OK 73112-4059

Phone #:
Fax #:
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Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
RITA DERIKS PA 4967
GREG WAYNE DINWIDDIE PA 1037
SHELBY MARIE FOGLER PA 5188
JOANNA LEE HART PA 1236
ERIN M KRUEGER PA 1866
LINDSEY CHALEE THOMAS PA 2699

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