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Last Update: Thursday, December 19, 2024 3:44 AM CST
Next Update: Thursday, December 19, 2024 12:00 PM CST
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FULLER, DOUGLAS CONRAD
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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.
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| Practice Address: |
4311 CARSWELL AVE BLDG 340
NELLIS AFB NV 89191
Address last updated on 6/4/2024 |
| Phone #: |
(801) 643-0307 |
| Fax #: |
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| County: |
NOT OKLAHOMA |
| License: |
15381 |
| Dated: |
8/19/1985 |
| Expires: |
8/1/2024 |
| License Type: |
Medical Doctor |
| Specialty: |
Family Medicine
Occupational Medicine
Aerospace Medicine |
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| Status: |
Inactive |
| Status Class: |
Physician Emeritus |
| Restricted to: |
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| Registered to Dispense: |
NO |
| Medical School: |
Univ Of Ut Sch Of Med, Salt Lake Cty Ut 84132 |
| Graduated: |
6 /
1982 |
| CME Year: |
2024 |
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Pending and/or Past Disciplinary Actions:
No Disciplinary Action Taken.
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All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
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| Certifications: |
AMERICAN BOARD OF FAMILY MEDICINE
AMERICAN BOARD OF PREVENTIVE MEDICINE (Occupational Medicine) |
| New Patients: |
No |
| Medicaid: |
No |
| Medicare: |
No |
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| HMO/PPO: |
None listed |
| Hospital Privileges: |
None listed |
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