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Oklahoma Board of Medical Licensure and Supervision

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SPENGOS, ALEXANDER THEODORE       
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: CHICKASAW NATION FAMILY PRACTICE CENTER
1007 N COUNTRY CLUB ROAD
ADA OK 74820-2847

Address last updated on 7/1/2000
Phone #: (580) 421-6219
Fax #:
County: PONTOTOC
License: 19871
Dated: 7/18/1996
Expires: 1/15/2003
Training Issued: 7/21/1995
Training Expires: 8/1/1996
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: 5 / 1995
CME Year: 2003
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 FAMILY MEDICINE
New Patients: No
Medicaid: No
Medicare: No
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
CHICKASAW NATION FAMILY PRACTICE CENTER
1007 N COUNTRY CLUB ROAD
ADA OK 74820-2847

Phone #: (580) 421-6219
Fax #:

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