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Oklahoma Board of Medical Licensure and Supervision

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COLLINS, ROGER BARRETT       
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: 15012 GAILLARDIA LANE
OKLAHOMA CITY OK 73142-1842

Address last updated on 6/25/2007
Phone #: (405) 359-0797
Fax #:
County: OKLAHOMA
License: 9872
Dated: 1/22/1973
Expires: 1/1/2008
License Type: Medical Doctor
Specialty: Diagnostic Radiology
Nuclear Radiology
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: UNIV OF TN, HLTH SCI CTR, COLL OF MED, MEMPHIS TN 38163
Graduated: 6 / 1967
CME Year: 2010
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 RADIOLOGY
New Patients: Yes
Medicaid: Yes
Medicare: Yes
   
HMO/PPO: Aetna PPO
BlueChoice PPO
HealthChoice
Preferred Community Choice
Hospital Privileges: INTEGRIS Baptist Medical Center
Oklahoma City, OK
INTEGRIS Baptist Portland Ave (fmly Deaconess Hospital)
Oklahoma City, OK
INTEGRIS Canadian Valley Regional Hospital
Yukon, OK
Northwest Surgical Hospital
Oklahoma City, OK
Locations: Hours: Languages:
15012 GAILLARDIA LANE
OKLAHOMA CITY OK 73142-1842

Phone #: (405) 359-0797
Fax #:
Mon: 8:00AM - 5:00PM
Tue: 8:00AM - 5:00PM
Wed: 8:00AM - 5:00PM
Thu: 8:00AM - 5:00PM
Fri:
Sat:
Sun: 8:00AM - 5:00PM

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