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Oklahoma Board of Medical Licensure and Supervision

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FOTEH, KOUSTA ISSA       
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: OKLAHOMA HEART HOSPITAL
4050 W MEMORIAL ROAD THIRD FLOOR
OKLAHOMA CITY OK 73120

Address last updated on 5/17/2012
Phone #: (405) 608-3800
Fax #: (405) 608-3838
County: OKLAHOMA
License: 27989
Dated: 7/1/2010
Expires: 7/1/2013
License Type: Medical Doctor
Specialty: General Surgery
Vascular Surgery
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: Univ of TX Med Sch at Houston, Houston Tx 77225
Graduated: 6 / 2003
CME Year: 2013
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 SURGERY
AMERICAN BOARD OF SURGERY - Vascular Surgery - General
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
OKLAHOMA HEART HOSPITAL
4050 W MEMORIAL ROAD THIRD FLOOR
OKLAHOMA CITY OK 73120

Phone #: (405) 608-3800
Fax #: (405) 608-3838

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