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Next Update: Thursday, December 19, 2024 2:50 AM CST
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NIDA, JERRY RAYMOND
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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: |
1812 DOVE COURT
EDMOND OK 73034-6104
Address last updated on 5/21/2008 |
| Phone #: |
(405) 340-9618 |
| Fax #: |
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| County: |
OKLAHOMA |
| License: |
7619 |
| Dated: |
6/1/1960 |
| Expires: |
6/1/2009 |
| License Type: |
Medical Doctor |
| Specialty: |
Pediatrics |
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| Status: |
Inactive |
| Status Class: |
Physician Emeritus |
| Restricted to: |
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| Registered to Dispense: |
YES |
| Medical School: |
Univ Of Ok Coll Of Med, Oklahoma City Ok 73190 |
| Graduated: |
/
1960 |
| CME Year: |
2010 |
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Pending and/or Past Disciplinary Actions:
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| Date |
Action |
Reasons |
Remarks |
| 3/27/2003 |
Probation Ended |
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| 3/14/2002 |
Probation |
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| 3/14/2002 |
Suspension, License |
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Board Filings and/or Orders:
03/27/2003
03/14/2002
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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 PEDIATRICS |
| New Patients: |
No |
| Medicaid: |
No |
| Medicare: |
No |
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| HMO/PPO: |
None listed |
| Hospital Privileges: |
None listed |
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