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FOUGEROUSSE, CARL EDWARD       
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: LAWTON COMMUNITY HEALTH CLINIC
5404 SW LEE BLVD
LAWTON OK 73505

Address last updated on 4/24/2017
Phone #: (580) 355-5242
Fax #:
County: COMANCHE
License: 27615
Dated: 5/6/2010
Expires: 5/1/2018
License Type: Medical Doctor
Specialty: Psychiatry
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: YES
Medical School: Univ Of Rochester Sch Of Med & Dentistry, Rochester Ny 14642
Graduated: 6 / 1969
CME Year: 2019
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 PSYCHIATRY AND NEUROLOGY
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: Southwestern Medical Center
Lawton, OK
Locations: Hours: Languages:
LAWTON COMMUNITY HEALTH CLINIC
5404 SW LEE BLVD
LAWTON OK 73505

Phone #: (580) 355-5242
Fax #:
Mon: 8:00AM - 4:00PM
Tue: 8:00AM - 4:00PM
Wed: 8:00AM - 4:00PM
Thu: 8:00AM - 0:00PM
Fri: 8:00AM - 4:00PM
Sat:
Sun:

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