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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Wednesday, May 1, 2024 4:08 AM CDT
Next Update: Wednesday, May 1, 2024 12:00 PM CDT

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DAVAULT, RANDALL JASON
Practice Address: 1706 DELIVERY LN.
DURANT OK 74701-2292

Address last updated on 7/3/2023
Phone #: (580) 920-2122
Fax #: (580) 920-9976
County: BRYAN
License: 23575
Dated: 8/1/2005
Expires: 8/1/2024
License Type: Medical Doctor
Specialty:
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: YES
Medical School: Univ Of Ok Coll Of Med, Oklahoma City Ok 73190
Graduated: 5 / 2003
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.
Certifications:
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: OU Medical Center
Oklahoma City, OK
V.A. Medical Center-OKC
Oklahoma City, OK
Locations: Hours: Languages:
1706 DELIVERY LN.
DURANT OK 74701-2292

Phone #: (580) 920-2122
Fax #: (580) 920-9976
Mon: 8:30AM - 5:00PM
Tue: 8:30AM - 5:00PM
Wed: 8:30AM - 5:00PM
Thu: 8:30AM - 5:00PM
Fri: 8:30AM - 1:00PM
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
ADAM DUANE HOGUE PA 1680
ASHLEY MARIE THOMANN PA 1831

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