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BANKS, MARK ALAN       
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: SOUTH SHREVEPORT ANESTHESIA SERVICES
2510 W. BERT KOUNS INDUSTRIAL LOOP
SHREVEPORT LA 71106

Address last updated on 11/27/2017
Phone #: (318) 212-5159
Fax #:
County: NOT OKLAHOMA
License: 33334
Dated: 10/17/2017
Expires: 10/1/2018
Temp. Lic. Issued: 9/8/2017
Temp. Lic. Expires: 11/2/2017
License Type: Medical Doctor
Specialty: Anesthesiology
Pediatric Anesthesiology (Pediatrics)
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: LSU Sch Of Med in Shreveport, Shreveport La 71130
Graduated: 5 / 2010
CME Year: 2020
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 ANESTHESIOLOGY
AMERICAN BOARD OF ANESTHESIOLOGY - Pediatric Anesthesiology
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
SOUTH SHREVEPORT ANESTHESIA SERVICES
2510 W. BERT KOUNS INDUSTRIAL LOOP
SHREVEPORT LA 71106

Phone #: (318) 212-5159
Fax #:

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