GOURD, JOHNSON CLINT JR. - Licensee Information

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Last Update: Friday, May 3, 2024 4:08 AM CDT
Next Update: Friday, May 3, 2024 12:00 PM CDT

GOURD, JOHNSON CLINT JR.

Practice Address:	JACK C MONTGOMERY VA 1100 HONOR HEIGHTS DRIVE MUSKOGEE OK 74401 Address last updated on 9/27/2023
Phone #:	(888) 397-8387
Fax #:
County:	MUSKOGEE
License:	23087
Dated:	10/1/2003
Expires:	10/1/2024
License Type:	Medical Doctor
Specialty:	Family Medicine

Status:	Active
Status Class:	Fully Licensed
Restricted to:
Registered to Dispense:	NO
Medical School:	Sanford Sch of Med of the Univ of SD, Vermillion, SD
Graduated:	5 / 2002
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 Blue Cross Blue Shield-Blue Preferred Blue Cross Blue Shield-Blue Traditional Blue Cross Blue Shield-Plan 65 Select BlueChoice PPO CIGNA HMO CIGNA PPO First Health HealthChoice Heartland Health Plan of Oklahoma Humana ChoiceCare Humana Medicare Advantage PPO Humana Tricare/PGBA Medicare Blue OSMA Health (formerly Plico PPO) Pacificare Commercial HMO Preferred Community Choice Railroad Medicare Secure Horizons HMO SoonerCare HMO SoonerCare PPO Tricare for Life Tricare Standard United Healthcare Choice United Healthcare EPO United Healthcare HMO United Healthcare Options PPO United Healthcare POS
Hospital Privileges:	None listed

Locations:	Hours:	Languages:
JACK C MONTGOMERY VA 1100 HONOR HEIGHTS DRIVE MUSKOGEE OK 74401 Phone #: (888) 397-8387 Fax #:	Mon: 8:00AM - 4:30PM Tue: 8:00AM - 4:30PM Wed: 8:00AM - 4:30PM Thu: 8:00AM - 4:30PM Fri: 8:00AM - 4:30PM Sat: Sun:	Spanish

Name:	Type:	License Number:	Full/Part Time:
Primary Supervisees(s):
NATHAN KYLE MANN	AT	686