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BRIXEY, CLARK JONATHAN       
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: EAGLE EYE RADIOLOGY
11307 B SUNSET HILLS ROAD
RESTON VA 20190

Address last updated on 6/3/2008
Phone #: (703) 652-1200
Fax #:
County: NOT OKLAHOMA
License: 25688
Dated: 7/19/2007
Expires: 7/1/2009
License Type: Medical Doctor
Specialty: Radiology
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: U OF CHGO DIV OF BIO SCI PRITZKER SCH OF MED, CHICAGO IL 60637
Graduated: 6 / 2002
CME Year: 2010
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:
EAGLE EYE RADIOLOGY
11307 B SUNSET HILLS ROAD
RESTON VA 20190

Phone #: (703) 652-1200
Fax #:

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