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LUCKETT, MARC ANDREW       
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: 608 NW 9TH #5100
OKLAHOMA CITY OK 73102
Phone #:
Fax #:
County: OKLAHOMA
License: 21154
Dated: 6/22/1999
Expires: 6/1/2003
License Type: Medical Doctor
Specialty: Obstetrics & Gynecology
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: ST LOUIS UNIV SCH OF MED, ST LOUIS MO 63104
Graduated: 6 / 1995
CME Year: 2005
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:
608 NW 9TH #5100
OKLAHOMA CITY OK 73102

Phone #:
Fax #:

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