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MIDDLETON, PHILIP J       
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: 8307 CONSTITUTION AVE NE
ALBUQUERQUE NM 87110
Phone #:
Fax #:
County: NOT OKLAHOMA
License: 20004
Dated: 11/5/1996
Expires: 11/1/2000
License Type: Medical Doctor
Specialty: Diagnostic Radiology
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: Med Coll Of Wi, Milwaukee Wi 53226
Graduated: 5 / 1969
CME Year: 2000
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 RADIOLOGY
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
8307 CONSTITUTION AVE NE
ALBUQUERQUE NM 87110

Phone #:
Fax #:

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