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Oklahoma Board of Medical Licensure and Supervision

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FORRISTALL, RONALD MARK       
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: 601 EAST 13TH STREET
SUITE G
GROVE OK 74344-2962

Address last updated on 9/13/2006
Phone #: (918) 786-3391
Fax #: (918) 786-7264
County: DELAWARE
License: 16738
Dated: 11/29/1988
Expires: 6/28/2007
License Type: Medical Doctor
Specialty: Orthopedic Surgery
Status: Inactive
Status Class: Deceased
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of Ok Coll Of Med, Oklahoma City Ok 73190
Graduated: 6 / 1984
CME Year: 2009
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 ORTHOPAEDIC SURGERY
New Patients: No
Medicaid: No
Medicare: No
   
HMO/PPO: Aetna PPO
BlueChoice PPO
CIGNA PPO
HealthChoice
Preferred Community Choice
United Healthcare Options PPO
Welcor/Sooner
Hospital Privileges: None listed
Locations: Hours: Languages:
601 EAST 13TH STREET
SUITE G
GROVE OK 74344-2962

Phone #: (918) 786-3391
Fax #: (918) 786-7264

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