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GRISHAM, CHARLES KEITH       
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: 504 OLD BUGLE ROAD
EDMOND OK 73003
Phone #:
Fax #:
County: OKLAHOMA
License: 20870
Dated: 8/13/1998
Expires: 8/1/2000
License Type: Medical Doctor
Specialty: Obstetrics & Gynecology
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of Tx Med Branch Galveston, Galveston Tx 77550
Graduated: 5 / 1996
CME Year: 2001
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:
504 OLD BUGLE ROAD
EDMOND OK 73003

Phone #:
Fax #:

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