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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Saturday, April 27, 2024 1:44 PM CDT
Next Update: Saturday, April 27, 2024 4:30 PM CDT

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JOHN, MICHAEL DAVID
Practice Address: 620 WEST 15TH STREET
EDMOND OK 73013-3617

Address last updated on 3/3/2022
Phone #: (405) 359-0551
Fax #: (405) 359-3061
County: OKLAHOMA
License: 15126
Dated: 5/9/1985
Expires: 5/1/2025
License Type: Medical Doctor
Specialty: Dermatology
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: NO
Medical School: UNIV OF LOUISVILLE SCH OF MED, LOUISVILLE KY 40202
Graduated: 5 / 1977
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.
Certifications: AMERICAN BOARD OF DERMATOLOGY
New Patients: Yes
Medicaid: No
Medicare: Yes
   
HMO/PPO: Aetna Elect Choice
Aetna HMO
Aetna Managed Choice
Aetna PPO
Blue Cross Blue Shield-Blue Preferred
Blue Cross Blue Shield-Blue Traditional
Blue Cross Blue Shield-Plan 65 Select
BlueChoice PPO
BlueLincs HMO
CIGNA HMO
CIGNA PPO
CommunityCare HMO, Inc
First Health
Galaxy Health Network
Global Health HMO
Great West Healthcare
Guidestar Health Systems
HealthChoice
Humana ChoiceCare
Humana Medicare Advantage PPO
One Health Plan PPO
OSMA Health (formerly Plico PPO)
Pacificare Commercial HMO
PacifiCare of Oklahoma, Inc
PHCS (Private Healthcare Systems)
Physicians Direct Network
Preferred Community Choice
Private Healthcare Systems (PHCS)
Railroad Medicare
Secure Horizons HMO
Tricare for Life
UniCare Health Plans of Oklahoma
United Healthcare Choice
United Healthcare HMO
United Healthcare Options PPO
United Healthcare POS
Hospital Privileges: Mercy Hospital OKC
Oklahoma City, OK
OU Medical Center - Edmond (frmrly Edmond Medical Center)
Edmond, OK
Locations: Hours: Languages:
620 WEST 15TH STREET
EDMOND OK 73013-3617

Phone #: (405) 359-0551
Fax #: (405) 359-3061
Mon: 8:00AM - 5:00PM
Tue: 8:00AM - 5:00PM
Wed: 8:00AM - 5:00PM
Thu:
Fri:
Sat:
Sun:
Spanish
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
MARIA PRUDHOMME APRN 10652

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