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COOGAN, MARY ALICE       
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: 3578 ARCADIA DRIVE
CARSON CITY NV 89705
Phone #:
Fax #:
County: NOT OKLAHOMA
License: 6356
Dated: 10/9/1952
Expires: 10/1/1997
License Type: Medical Doctor
Specialty: Internal Medicine
Status: Inactive
Status Class: Retired
Restricted to:
Registered to Dispense: NO
Medical School: CREIGHTON UNIV SCH OF MED, OMAHA NE 68178
Graduated: / 1951
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: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
3578 ARCADIA DRIVE
CARSON CITY NV 89705

Phone #:
Fax #:

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