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Oklahoma Board of Medical Licensure and Supervision

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HAZLITT, HENRY ANDREW       
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: 1701 TORRES ROAD
EDMOND OK 73034-2547
Phone #:
Fax #:
County: OKLAHOMA
License: 17428
Dated: 8/6/1990
Expires: 6/30/1994
Temp. Lic. Issued: 7/5/1990
Temp. Lic. Expires: 9/1/1990
License Type: Medical Doctor
Specialty: Cardiovascular Disease
Internal Medicine
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: YES
Medical School: LSU Sch Of Med in New Orleans, New Orleans La 70112
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: AMERICAN BOARD OF INTERNAL MEDICINE
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
1701 TORRES ROAD
EDMOND OK 73034-2547

Phone #:
Fax #:

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