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MATSUMOTO, ANDREW       
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: NEWMAN MEMORIAL HEALTH
905 MAIN ST.
SHATTUCK OK 73858

Address last updated on 5/20/2021
Phone #:
Fax #:
County: ELLIS
License: 34864
Dated: 6/1/2019
Expires: 6/1/2022
License Type: Medical Doctor
Specialty: Dermatology
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: Albany Med Coll, Albany NY 12208
Graduated: 5 / 2017
CME Year: 2022
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:
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
NEWMAN MEMORIAL HEALTH
905 MAIN ST.
SHATTUCK OK 73858

Phone #:
Fax #:
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:

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