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GRAHAM, DERREL DEWAYNE JR       
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: LSU HLTH SCIENCES CTR
1501 KINGS HIGHWAY
PO BOX 33932
SHREVEPORT LA 71130-3932

Address last updated on 3/14/2000
Phone #:
Fax #:
County: NOT OKLAHOMA
License: 19708
Dated: 5/6/1996
Expires: 5/1/2002
License Type: Medical Doctor
Specialty: Emergency Medicine
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: LSU Sch Of Med in Shreveport, Shreveport La 71130
Graduated: 5 / 1992
CME Year: 2004
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 EMERGENCY MEDICINE
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
LSU HLTH SCIENCES CTR
1501 KINGS HIGHWAY
PO BOX 33932
SHREVEPORT LA 71130-3932

Phone #:
Fax #:

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