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Oklahoma Board of Medical Licensure and Supervision

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LONG, LEROY III       
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: 1413 CANTERBURY PLACE
OKLAHOMA CITY OK 73116-5501
Phone #:
Fax #:
County: OKLAHOMA
License: 6897
Dated: 8/9/1956
Expires: 8/1/1998
License Type: Medical Doctor
Specialty: General Surgery
Status: Inactive
Status Class: Deceased
Restricted to:
Registered to Dispense: YES
Medical School: Harvard Med Sch, Boston Ma 02115
Graduated: / 1955
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: AMERICAN BOARD OF SURGERY
New Patients: No
Medicaid: No
Medicare: No
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
1413 CANTERBURY PLACE
OKLAHOMA CITY OK 73116-5501

Phone #:
Fax #:

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