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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Saturday, December 21, 2024 3:49 AM CST
Next Update: Saturday, December 21, 2024 12:00 PM CST

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DITOMMASO, CHAUNTEL JOYCE       
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: 1201 E JACKSON ST
HUGO OK 74743-4229

Address last updated on 2/24/2024
Phone #: (580) 326-6423
Fax #: (580) 317-9233
County: CHOCTAW
License: 2570
Dated: 1/14/2016
Expires: 3/31/2025
License Type: Physician Assistant
Specialty:
Status: Active
Status Class: Fully Licensed
Restricted to:
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.
Locations: Hours: Languages:
1201 E JACKSON ST
HUGO OK 74743-4229

Phone #: (580) 326-6423
Fax #: (580) 317-9233

Hospital Privileges:

Atoka Memorial Hospital
Atoka, OK
Choctaw Memorial Hospital
Hugo, OK
Pushmataha Hospital
Antlers, OK

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
DAVID CAMPBELL DO 4465
VICTORIA E. PARDUE DO 2840

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