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LONG, JOHN WALTER       
This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.
Practice Address: 3155 KEARNEY ST
SUITE 170
FREMONT CA 94538

Address last updated on 12/23/1999
Phone #:
Fax #:
County: NOT OKLAHOMA
License: 10000
Dated: 6/15/1973
Expires: 6/30/1990
License Type: Medical Doctor
Specialty: Psychiatry
Status: Inactive
Status Class: Deceased
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of Ok Coll Of Med, Oklahoma City Ok 73190
Graduated: / 1971
CME Year:
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 PSYCHIATRY AND NEUROLOGY
New Patients: No
Medicaid: No
Medicare: No
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
3155 KEARNEY ST
SUITE 170
FREMONT CA 94538

Phone #:
Fax #:

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