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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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HICKMAN, JEFFERY CHARLES
Practice Address: VARIETY CARE
201 1ST STREET
GRANDFIELD OK 73546

Address last updated on 3/29/2024
Phone #: (405) 632-6688
Fax #:
County: TILLMAN
License: 1298
Dated: 11/20/2003
Expires: 3/31/2025
License Type: Physician Assistant
Specialty:
Status: Active
Status Class: Fully Licensed
Restricted to:
CME Year: 2025
Pending and/or Past Disciplinary Actions:
Date Action Reasons Remarks
1/28/2021 Probation Ended
1/28/2016 License Reinstated
6/13/2014 Surrendered License
4/1/2014 Complaint Citation
5/5/2005 Probation
Board Filings and/or Orders:
02/02/2016
07/29/2015
06/13/2014
05/23/2014
03/28/2014
03/28/2014
05/05/2005
03/24/2005
03/24/2005
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Locations: Hours: Languages:
VARIETY CARE
201 1ST STREET
GRANDFIELD OK 73546

Phone #: (405) 632-6688
Fax #:

Hospital Privileges:

None listed

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
GLENN DAVIS MD 38899
ASHISH DUSHANT GUPTA MDC 41517
HENRY DEAN VAUGHAN DO 2031

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