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Oklahoma Board of Medical Licensure and Supervision

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HOLDER, BLAIR THOMAS       
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: 1202 W CHEROKEE
WAGONER OK 74467
Phone #:
Fax #:
County: WAGONER
License: 13320
Dated: 9/15/1981
Expires: 6/30/1988
License Type: Medical Doctor
Specialty: Internal Medicine
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: Wayne State Univ SOM, Detroit Mi 48201
Graduated: 6 / 1978
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 INTERNAL MEDICINE
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
1202 W CHEROKEE
WAGONER OK 74467

Phone #:
Fax #:

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