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GIGNAC, MARC RENE       
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: 720 141ST ST NW
EDMOND OK 73013
Phone #:
Fax #:
County: OKLAHOMA
License: 17474
Dated: 9/17/1990
Expires: 6/30/1995
License Type: Medical Doctor
Specialty: Urology
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: YES
Medical School: Tx Tech Univ Hlth Sci Ctr Sch Of Med, Lubbock Tx 79430
Graduated: 5 / 1989
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:
720 141ST ST NW
EDMOND OK 73013

Phone #:
Fax #:

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