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WYSONG, CLARK BENNETT III       
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: FAMILY PRACTICE SPECIALISTS
4319 NORTH 32ND STREET
PHOENIX AZ 85018
Phone #:
Fax #:
County: NOT OKLAHOMA
License: 19521
Dated: 8/24/1995
Expires: 8/1/1998
Training Issued: 6/23/1994
Training Expires: 6/1/1996
License Type: Medical Doctor
Specialty: Family Medicine
Emergency Medicine
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of Ok Coll Of Med, Oklahoma City Ok 73190
Graduated: 6 / 1994
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:
FAMILY PRACTICE SPECIALISTS
4319 NORTH 32ND STREET
PHOENIX AZ 85018

Phone #:
Fax #:

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