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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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PERCIVAL, CARMEN ANNETTE       
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: LAWTON IHS
1515 LAWRIE TATUM RD
LAWTON OK 73507

Address last updated on 5/30/2024
Phone #: (580) 354-5404
Fax #: (580) 354-5409
County: COMANCHE
License: 998
Dated: 3/8/2000
Expires: 3/31/2025
Temp. Ltr. Issued: 1/7/2000
Temp. Ltr. Expires: 3/11/2000
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:
LAWTON IHS
1515 LAWRIE TATUM RD
LAWTON OK 73507

Phone #: (580) 354-5404
Fax #: (580) 354-5409

Hospital Privileges:

USPHS Lawton Indian Hospital
Lawton, OK

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
MANUEL JOSE DELAROSA MD 21197
MICHAEL LYNN GEARHART DO 4637

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