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Oklahoma Board of Medical Licensure and Supervision

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DEACON, THOMAS WALTER       
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: 1901 NW 36TH ST
OKLAHOMA CITY OK 73118
Phone #:
Fax #:
County: OKLAHOMA
License: 16500
Dated: 7/1/1988
Expires: 6/30/1990
Training Issued: 11/2/1987
Training Expires: 9/30/1988
License Type: Medical Doctor
Specialty: Pediatrics
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: YES
Medical School: Univ of TX at San Antonio, UTSA Long School of Medicine
Graduated: 5 / 1987
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:
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
1901 NW 36TH ST
OKLAHOMA CITY OK 73118

Phone #:
Fax #:

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