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Oklahoma Board of Medical Licensure and Supervision

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BASHAM, BRIAN ERIC       
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: CARE ATC
9902-A E 43RD STREET
TULSA OK 74146

Address last updated on 10/12/2010
Phone #: (866) 417-0114
Fax #:
County: TULSA
License: 27461
Dated: 11/12/2009
Expires: 11/1/2011
License Type: Medical Doctor
Specialty: Family Medicine
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of KS Sch Of Med, Kansas City Ks 66103
Graduated: 5 / 1988
CME Year: 2012
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:
CARE ATC
9902-A E 43RD STREET
TULSA OK 74146

Phone #: (866) 417-0114
Fax #:

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