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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Thursday, December 19, 2024 3:44 AM CST
Next Update: Thursday, December 19, 2024 12:00 PM CST

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RUSSELL, THOMAS RYAN       
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: OKLAHOMA CITY CLINIC
701 NE 10TH STREET
OKLAHOMA CITY OK 73104-5400

Address last updated on 4/22/2014
Phone #: (405) 280-5550
Fax #: (405) 280-5230
County: OKLAHOMA
License: 8452
Dated: 6/16/1965
Expires: 3/22/2015
License Type: Medical Doctor
Specialty: Cardiovascular Disease
Status: Inactive
Status Class: Deceased
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of Ok Coll Of Med, Oklahoma City Ok 73190
Graduated: / 1965
CME Year: 2016
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
AMERICAN BOARD OF INTERNAL MEDICINE - Cardiovascular Disease
New Patients: No
Medicaid: No
Medicare: No
   
HMO/PPO: BlueChoice PPO
BlueLincs HMO
PacifiCare of Oklahoma, Inc
Hospital Privileges: None listed
Locations: Hours: Languages:
OKLAHOMA CITY CLINIC
701 NE 10TH STREET
OKLAHOMA CITY OK 73104-5400

Phone #: (405) 280-5550
Fax #: (405) 280-5230

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