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Oklahoma Board of Medical Licensure and Supervision

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TRACY, GILBERT WAYNE       
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: 4405 FONDULAC
MUSKOGEE OK 74401-6741
Phone #:
Fax #:
County: MUSKOGEE
License: 4728
Dated: 7/24/1939
Expires: 6/30/1991
License Type: Medical Doctor
Specialty: General Practice
Status: Inactive
Status Class: Deceased
Restricted to:
Registered to Dispense: YES
Medical School: Univ Of Ok Coll Of Med, Oklahoma City Ok 73190
Graduated: / 1938
CME Year:
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: No
Medicaid: No
Medicare: No
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
4405 FONDULAC
MUSKOGEE OK 74401-6741

Phone #:
Fax #:

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