Search Results
Last Update: Thursday, December 19, 2024 3:44 AM CST
Next Update: Thursday, December 19, 2024 12:00 PM CST
Return to Search Licensees page
|
GUSTAFSON, JON MARK
|
|
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: |
CNSA NEUROLOGY
320 NORTH GREENWOOD AVENUE
FORT SMITH AR 72901
Address last updated on 7/23/2024 |
| Phone #: |
(479) 434-2743 |
| Fax #: |
(844) 454-8351 |
| County: |
NOT OKLAHOMA |
| License: |
29137 |
| Dated: |
9/10/2012 |
| Expires: |
9/1/2025 |
|
Temp.
Lic.
Issued:
|
6/15/2012 |
|
Temp.
Lic.
Expires:
|
9/14/2012 |
| License Type: |
Medical Doctor |
| Specialty: |
Neurology |
|
| Status: |
Active |
| Status Class: |
Fully Licensed |
| Restricted to: |
|
| Registered to Dispense: |
NO |
| Medical School: |
ORAL ROBERTS UNIV SCH OF MED, TULSA OK 74137 |
| Graduated: |
5 /
1987 |
| CME Year: |
2027 |
|
|
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: |
UNITED COUNCIL FOR NEUROLOGIC SUBSPECIALTIES
AMERICAN BOARD OF PSYCHIATRY AND NEUROLOGY (Neurology specific) |
| New Patients: |
Yes |
| Medicaid: |
Yes |
| Medicare: |
Yes |
| |
|
| HMO/PPO: |
None listed |
| Hospital Privileges: |
Hospital(s) Not In Oklahoma
,
|
|
|
|
|
Return to Search Licensees page
