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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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DEWILDE, RAEGAN       
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: FAIRVIEW REGIANL MEDICAL CENTER
523 E STATE RD
FAIRVIEW OK 73737

Address last updated on 3/27/2024
Phone #: (580) 227-2585
Fax #:
County: MAJOR
License: 4698
Dated: 11/2/2021
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:
FAIRVIEW REGIANL MEDICAL CENTER
523 E STATE RD
FAIRVIEW OK 73737

Phone #: (580) 227-2585
Fax #:

Hospital Privileges:

None listed

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
JOHN STEPHEN PRICE MD 16520

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