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Oklahoma Board of Medical Licensure and Supervision

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WILLIS, TED SCOTT       
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: 15100 TODD WAY
OKLAHOMA CITY OK 73170
Phone #:
Fax #:
County: OKLAHOMA
License: 16565
Dated: 7/1/1988
Expires: 6/30/1991
Training Issued: 8/19/1987
Training Expires: 9/30/1988
License Type: Medical Doctor
Specialty: Diagnostic Radiology
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: Univ of TX at San Antonio, UTSA Long School of Medicine
Graduated: 5 / 1986
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:
15100 TODD WAY
OKLAHOMA CITY OK 73170

Phone #:
Fax #:

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