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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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FALCONER, RALPH TILLMAN       
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: FAMILY HEALTH CENTER OF SOUTHERN OKLAHOMA
610 EAST 24TH STREET
TISHOMINGO OK 73460

Address last updated on 3/13/2024
Phone #: (580) 371-2343
Fax #: (580) 371-2451
County: JOHNSTON
License: 670
Dated: 6/24/1994
Expires: 3/31/2025
Temp. Ltr. Issued: 4/14/1994
Temp. Ltr. Expires: 7/23/1994
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:
FAMILY HEALTH CENTER OF SOUTHERN OKLAHOMA
610 EAST 24TH STREET
TISHOMINGO OK 73460

Phone #: (580) 371-2343
Fax #: (580) 371-2451

Hospital Privileges:

None listed

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
WILSON LLOYD DAVIS JR. MD 34304
HANS FICHTENBERG DO 1461
HEIDI LYNNE HAISLIP MD 28183
Stephanie Jones DO 7379
STEPHEN KHOURY DO 3769
PAUL REEL DO 3340
BRIAN MICHAEL SHOCKEY MD 18264

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