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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Friday, December 20, 2024 6:44 PM CST
Next Update: Saturday, December 21, 2024 2:50 AM CST

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GORANTLA, RAM GAUTAM       
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: MERCY HOSPITAL
430 N MONTE VISTA ST
ADA OK 74820

Address last updated on 10/11/2021
Phone #: (580) 332-2323
Fax #:
County: PONTOTOC
License: 38769
Dated: 9/23/2021
Expires: 9/1/2024
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:
MERCY HOSPITAL
430 N MONTE VISTA ST
ADA OK 74820

Phone #: (580) 332-2323
Fax #:

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