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BLAKE, BRIAN EUGENE       
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: 191 N. HWY 10/59
PO BOX 166
KANSAS OK 74347

Address last updated on 5/4/2021
Phone #: (918) 868-5701
Fax #: (918) 868-5703
County: DELAWARE
License: 21213
Dated: 7/7/1999
Expires: 4/28/2023
License Type: Medical Doctor
Specialty: Internal Medicine
Bariatric Medicine
Emergency 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 / 1998
CME Year: 2023
Pending and/or Past Disciplinary Actions:
Date Action Reasons Remarks
9/23/2010 Complaint Citation
#1/1/1900# Past Disciplinary Action
Board Filings and/or Orders:
05/19/2011
04/15/2011
09/23/2010
09/23/2010
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Certifications:
New Patients: No
Medicaid: No
Medicare: No
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
191 N. HWY 10/59
PO BOX 166
KANSAS OK 74347

Phone #: (918) 868-5701
Fax #: (918) 868-5703

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