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Oklahoma Board of Medical Licensure and Supervision

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BRADLEY, FENWICK PHILIP       
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: 427 SEMINOLE DRIVE
MONTGOMERY AL 36117
Phone #:
Fax #:
County: NOT OKLAHOMA
License: 14879
Dated: 7/6/1984
Expires: 7/1/1999
License Type: Medical Doctor
Specialty: Anatomic Pathology
Clinical Pathology
Status: Inactive
Status Class: Deceased
Restricted to:
Registered to Dispense: NO
Medical School: G WASHINGTON UNIV SCH MED & HLTH SCI, WASHINGTON DC 20037
Graduated: 6 / 1963
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 PATHOLOGY
New Patients: No
Medicaid: No
Medicare: No
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
427 SEMINOLE DRIVE
MONTGOMERY AL 36117

Phone #:
Fax #:

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