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AZEEM, FAZILAT       
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: JIM TALIAFERRO COMMUNITY MENTAL HEALTH CENTER
602 SW 38 STREET
LAWTON OK 73505-6912

Address last updated on 5/6/2022
Phone #: (580) 248-5780
Fax #:
County: COMANCHE
License: 22011
Dated: 7/2/2002
Expires: 7/1/2023
License Type: Medical Doctor
Specialty: Psychiatry
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: Gov't Med Coll, Nagpur Univ, Nagpur, Maharashtra, India
Graduated: 9 / 1981
CME Year: 2023
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:
JIM TALIAFERRO COMMUNITY MENTAL HEALTH CENTER
602 SW 38 STREET
LAWTON OK 73505-6912

Phone #: (580) 248-5780
Fax #:
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1222 NW Cache Rd
lawton, OK 73507

Phone #: (580) 355-5500
Fax #: (11) 201-
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Hindi

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