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Oklahoma Board of Medical Licensure and Supervision

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DOUMONT, SULLIVAN PAIGE       
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: ACCESS MEDICAL CENTER
9917 SE 15TH ST
MIDWEST CITY OK 73130

Address last updated on 8/16/2016
Phone #: (405) 622-2080
Fax #:
County: OKLAHOMA
License: 2647
Dated: 2/3/2016
Expires: 3/31/2017
License Type: Physician Assistant
Specialty:
Status: Inactive
Status Class: Expired License
Restricted to:
CME Year: 2017
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:
ACCESS MEDICAL CENTER
9917 SE 15TH ST
MIDWEST CITY OK 73130

Phone #: (405) 622-2080
Fax #:

Hospital Privileges:

None listed

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