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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Friday, September 27, 2024 3:50 AM CDT
Next Update: Friday, September 27, 2024 12:00 PM CDT

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BUSTAMANTE, MARK ANTHONY       
Practice Address: OAK STREET HEALTH-SOUTH OKLAHOMA CITY
2130 SW 59TH ST
OKLAHOMA CITY OK 73119

Address last updated on 7/12/2021
Phone #: (888) 387-7209
Fax #:
County: OKLAHOMA
License: 38544
Dated: 7/12/2021
Expires: 7/1/2022
License Type: Medical Doctor
Specialty:
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
CME Year: 2024
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:
OAK STREET HEALTH-SOUTH OKLAHOMA CITY
2130 SW 59TH ST
OKLAHOMA CITY OK 73119

Phone #: (888) 387-7209
Fax #:

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