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COUCH, ELLIS PHILLIP       
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: 103 NORTH 37TH STREET
MUSKOGEE OK 74401-2122
Phone #: (918) 683-3086
Fax #: (918) 683-1637
County: MUSKOGEE
License: 11662
Dated: 3/22/1978
Expires: 3/1/2008
License Type: Medical Doctor
Specialty: Orthopedic Surgery
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: YES
Medical School: Baylor Coll Of Med, Houston Tx 77030
Graduated: / 1968
CME Year: 2010
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 ORTHOPAEDIC SURGERY
New Patients: No
Medicaid: No
Medicare: No
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
103 NORTH 37TH STREET
MUSKOGEE OK 74401-2122

Phone #: (918) 683-3086
Fax #: (918) 683-1637
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:

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