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WIDEMON, WILLIE HENRY       
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: 3577 PLEASANT HOLLOW DRIVE
APT #91
MEMPHIS TN 38115
Phone #:
Fax #:
County: NOT OKLAHOMA
License: 18026
Dated: 7/1/1992
Expires: 6/30/1995
License Type: Medical Doctor
Specialty: Family Medicine
Status: Inactive
Status Class: Deceased
Restricted to:
Registered to Dispense: YES
Medical School: Univ Of Ok Coll Of Med, Oklahoma City Ok 73190
Graduated: 6 / 1991
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: No
Medicaid: No
Medicare: No
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
3577 PLEASANT HOLLOW DRIVE
APT #91
MEMPHIS TN 38115

Phone #:
Fax #:

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