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Oklahoma Board of Medical Licensure and Supervision

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SPENCER, THEODORE       
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: 1530 SW 89TH
SUITE A-1
OKLAHOMA CITY OK 73159-6307
Phone #:
Fax #:
County: OKLAHOMA
License: 12110
Dated: 2/5/1979
Expires: 6/5/2001
License Type: Medical Doctor
Specialty: Family Medicine
Status: Inactive
Status Class: Deceased
Restricted to:
Registered to Dispense: YES
Medical School: MEXICO MEDICAL SCHOOLS
Graduated: / 1976
CME Year: 2001
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 FAMILY MEDICINE
New Patients: No
Medicaid: No
Medicare: No
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
1530 SW 89TH
SUITE A-1
OKLAHOMA CITY OK 73159-6307

Phone #:
Fax #:

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