WILSON, VIVIAN LAVERNE - Licensee Information

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Last Update: Saturday, May 11, 2024 6:57 PM CDT
Next Update: Sunday, May 12, 2024 2:50 AM CDT

WILSON, VIVIAN LAVERNE

Practice Address:	MARY MAHONEY MEMORIAL HEALTH CENTER 12716 N.E. 36TH STREET P O BOX 30589 OKLAHOMA CITY OK 73140 Address last updated on 7/25/2023
Phone #:	(405) 769-3301
Fax #:	(405) 769-0290
County:	OKLAHOMA
License:	11902
Dated:	8/11/1978
Expires:	8/1/2024
License Type:	Medical Doctor
Specialty:	Family Medicine

Status:	Active
Status Class:	Fully Licensed
Restricted to:
Registered to Dispense:	YES
Medical School:	Univ Of Colorado Sch Of Med (frmly in Denver)
Graduated:	/ 1977
CME Year:	2024

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.

Certifications:
New Patients:	Yes
Medicaid:	Yes
Medicare:	Yes

HMO/PPO:	Aetna Elect Choice Aetna HMO Aetna Managed Choice Aetna PPO Beechstreet PPO Blue Cross Blue Shield-Blue Preferred Blue Cross Blue Shield-Blue Traditional BlueChoice PPO BlueLincs HMO CIGNA HMO CommunityCare HMO, Inc CommunityCare Senior HMO Coventry Health Care National Network HealthChoice Medicare Blue Pacificare Commercial HMO PacifiCare of Oklahoma, Inc Preferred Community Choice Prudential Health Care Plan, Inc Secure Horizons HMO SoonerCare HMO SoonerCare PPO United Healthcare Choice United Healthcare EPO United Healthcare HMO United Healthcare Options PPO United Healthcare POS Welcor/Sooner
Hospital Privileges:	None listed

Locations:	Hours:	Languages:
MARY MAHONEY MEMORIAL HEALTH CENTER 12716 N.E. 36TH STREET P O BOX 30589 OKLAHOMA CITY OK 73140 Phone #: (405) 769-3301 Fax #: (405) 769-0290	Mon: Tue: Wed: Thu: Fri: Sat: Sun:

Name:	Type:	License Number:
Primary Supervisees(s):
SHIJY JOYKUTTY	APRN	86902
LIJI SEILAS	APRN	81805
BEENA THOMAS	APRN	94626