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WEISE, TIMOTHY JOHN       
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: DEPARTMENT OF FAMILY & COMMUNITY MEDICINE
MARICOPA MEDICAL CENTER
2601 EAST ROOSEVELT
PHOENIX AZ 85008

Address last updated on 4/19/2006
Phone #: (602) 344-5426
Fax #:
County: NOT OKLAHOMA
License: 24900
Dated: 4/19/2006
Expires: 4/1/2007
License Type: Medical Doctor
Specialty: Family Medicine
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: Rutgers Robt W Johnson Med Sch, (fmly UMDNJ)
Graduated: 5 / 1998
CME Year: 2009
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 FAMILY MEDICINE
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
DEPARTMENT OF FAMILY & COMMUNITY MEDICINE
MARICOPA MEDICAL CENTER
2601 EAST ROOSEVELT
PHOENIX AZ 85008

Phone #: (602) 344-5426
Fax #:

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