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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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AVILA, HOMERO       
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: JACKSON COUNTY MEMORIAL HOSPITAL
1200 E.PECAN
ALTUS OK 73521

Address last updated on 11/10/2023
Phone #: (580) 379-5244
Fax #:
County: JACKSON
License: 4035
Dated: 11/7/2013
Expires: 11/30/2025
License Type: Respiratory Care Practitioner
Specialty:
Status: Active
Status Class: Fully Licensed
Restricted to:
CME Year: 0
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:
JACKSON COUNTY MEMORIAL HOSPITAL
1200 E.PECAN
ALTUS OK 73521

Phone #: (580) 379-5244
Fax #:
Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
JUAN CARLOS MENDOZA RC 903

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