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Oklahoma Board of Medical Licensure and Supervision

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STACK, LAWRENCE BENEDICT       
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: VANDERBILT U/DPT EMERGENCY MED
1313 21ST AVENUE SOUTH
703 OXFORD HOUSE
NASHVILLE TN 37232-4700
Phone #:
Fax #:
County: NOT OKLAHOMA
License: 16725
Dated: 11/18/1988
Expires: 11/1/2000
License Type: Medical Doctor
Specialty: Emergency Medicine
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: ORAL ROBERTS UNIV SCH OF MED, TULSA OK 74137
Graduated: 5 / 1987
CME Year: 2000
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 EMERGENCY MEDICINE
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
VANDERBILT U/DPT EMERGENCY MED
1313 21ST AVENUE SOUTH
703 OXFORD HOUSE
NASHVILLE TN 37232-4700

Phone #:
Fax #:

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