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Oklahoma Board of Medical Licensure and Supervision

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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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BALZER, LARRY DALE       
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: 1309 EAST STREET
GUYMON OK 73942

Address last updated on 5/8/2024
Phone #: (580) 338-4638
Fax #: (580) 338-4642
County: TEXAS
License: 9795
Dated: 6/30/1972
Expires: 6/1/2025
License Type: Medical Doctor
Specialty: Family Medicine
GERIATRICS
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: YES
Medical School: Univ Of Ok Coll Of Med, Oklahoma City Ok 73190
Graduated: 6 / 1971
CME Year: 2025
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 FAMILY MEDICINE
New Patients: Yes
Medicaid: Yes
Medicare: Yes
   
HMO/PPO: Aetna HMO
Aetna PPO
Beechstreet PPO
Blue Cross Blue Shield-Blue Preferred
Blue Cross Blue Shield-Blue Traditional
Blue Cross Blue Shield-Plan 65 Select
BlueChoice PPO
CCN Managed Care
CIGNA PPO
CommunityCare HMO, Inc
CommunityCare Senior HMO
Coventry Health Care National Network
Evolutions Healthcare
First Health
HealthChoice
Humana ChoiceCare
Humana Tricare/PGBA
Multiplan PPO
Oklahoma Health Network PPO
Pacificare Commercial HMO
PacifiCare of Oklahoma, Inc
Physicians Direct Network
PPO Oklahoma
PPO USA
Preferred Community Choice
Preferred Health Network-ppoNEXT
Pronet
Secure Horizons HMO
SoonerCare HMO
United Healthcare EPO
United Healthcare Options PPO
United Healthcare POS
Hospital Privileges: None listed
Locations: Hours: Languages:
1309 EAST STREET
GUYMON OK 73942

Phone #: (580) 338-4638
Fax #: (580) 338-4642
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:
Spanish
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
SELENE GARCIA-VAN CAMP APRN 5663
TASHA HERRERA APRN 116758
ELIZABETH UMEMBA APRN 135049
KIMBERLY WADLEY APRN 72715

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