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CARMODY, PHILLIP WILLIAM       
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: 9108 CAMINO DEL SOL NE
ALBUQUERQUE NM 87111

Address last updated on 7/20/2005
Phone #:
Fax #:
County: NOT OKLAHOMA
License: 20000
Dated: 11/5/1996
Expires: 11/1/2001
License Type: Medical Doctor
Specialty: Diagnostic Radiology
Nuclear Medicine
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of Ne Coll Of Med, Omaha Ne 68198
Graduated: 5 / 1968
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 NUCLEAR MEDICINE
AMERICAN BOARD OF RADIOLOGY
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
9108 CAMINO DEL SOL NE
ALBUQUERQUE NM 87111

Phone #:
Fax #:

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