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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Tuesday, December 24, 2024 3:49 AM CST
Next Update: Tuesday, December 24, 2024 12:00 PM CST

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HAMMERVOLD, MATTHEW TODD       
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: MERCY
200 S. ACADEMY RD.
GUTHRIE OK 73044

Address last updated on 12/18/2024
Phone #: (405) 260-4213 x0000
Fax #:
County: LOGAN
License: 6239
Dated: 10/4/2022
Expires: 1/31/2026
Temp. Ltr. Issued: 6/17/2022
Temp. Ltr. Expires: 11/17/2022
License Type: Physical Therapist
Specialty:
Status: Active
Status Class: Fully Licensed
Restricted to:
CME Year: 2026
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:
MERCY
200 S. ACADEMY RD.
GUTHRIE OK 73044

Phone #: (405) 260-4213 x0000
Fax #:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
KAITLIN PAIGE CLARK TA 3585
CANDACE LEA DENSON TA 1499
KYLER DEAN HENSLEY TA 3690
KIMBERLY DAWN MCSWAIN TA 621
RONDA DIANNE PIERSALL TA 1782
JENNIFER ROSE WHITE TA 2000
JENNIFER ROSE WHITE TA 2000
VANESSA ANN WILCZEK TA 2282

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