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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Thursday, December 19, 2024 3:44 AM CST
Next Update: Thursday, December 19, 2024 12:00 PM CST

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WOLRAICH, MARK LEE       
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: 1100 NE 13TH STREET
OU CHILD STUDY CENTER
OKLAHOMA CITY OK 73117-1099

Address last updated on 6/14/2019
Phone #: (405) 761-1681 x45124
Fax #: (405) 271-2510
County: OKLAHOMA
License: 22350
Dated: 7/10/2001
Expires: 1/30/2021
License Type: Medical Doctor
Specialty: Developmental-Behavioral Pediatrics
Pediatrics
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: YES
Medical School: SUNY Upstate Med Univ, Syracuse, NY 13210
Graduated: 6 / 1970
CME Year: 2022
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 PEDIATRICS
AMERICAN BOARD OF PEDIATRICS - Developmental-Behavioral Pediatrics
New Patients: Yes
Medicaid: Yes
Medicare: No
   
HMO/PPO: Aetna HMO
Aetna PPO
BlueChoice PPO
BlueLincs HMO
CommunityCare HMO, Inc
HealthChoice
PacifiCare of Oklahoma, Inc
Preferred Community Choice
Prime Advantage Health Plan
Prudential Health Care Plan, Inc
United Healthcare HMO
United Healthcare Options PPO
Welcor/Sooner
Hospital Privileges: OU Health Medical Center
Oklahoma City, OK
Locations: Hours: Languages:
1100 NE 13TH STREET
OU CHILD STUDY CENTER
OKLAHOMA CITY OK 73117-1099

Phone #: (405) 761-1681 x45124
Fax #: (405) 271-2510
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:

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