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CHITWOOD, GORDON GLEN JR       
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: 2710 RIFE MEDICAL LANE
MERCY MEDICAL CENTER
RADIOLOGY DEPT.
ROGERS AR 72758

Address last updated on 6/29/2011
Phone #: (479) 338-8000 x2165
Fax #: (479) 254-3867
County: NOT OKLAHOMA
License: 11782
Dated: 7/1/1978
Expires: 7/1/2012
License Type: Medical Doctor
Specialty: Diagnostic Radiology
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of AR Coll Of Med, Little Rock AR 72205
Graduated: / 1977
CME Year: 2012
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 RADIOLOGY
New Patients: Yes
Medicaid: Yes
Medicare: Yes
   
HMO/PPO: None listed
Hospital Privileges: Hospital(s) Not In Oklahoma
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Locations: Hours: Languages:
2710 RIFE MEDICAL LANE
MERCY MEDICAL CENTER
RADIOLOGY DEPT.
ROGERS AR 72758

Phone #: (479) 338-8000 x2165
Fax #: (479) 254-3867
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun: 24HRS/7DAYS

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