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Last Update: Thursday, December 19, 2024 3:44 AM CST
Next Update: Thursday, December 19, 2024 12:00 PM CST
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WOOTAN, GEORGE ALLEN
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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.
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| Practice Address: |
10802 HACHITA DRIVE
PORT RICHEY FL 34668-2753
Address last updated on 5/20/2024 |
| Phone #: |
(617) 909-7523 |
| Fax #: |
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| County: |
NOT OKLAHOMA |
| License: |
8376 |
| Dated: |
6/12/1963 |
| Expires: |
7/1/2025 |
| License Type: |
Medical Doctor |
| Specialty: |
Family Medicine |
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| Status: |
Active |
| Status Class: |
Fully Licensed |
| Restricted to: |
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| Registered to Dispense: |
NO |
| Medical School: |
Univ Of Ok Coll Of Med, Oklahoma City Ok 73190 |
| Graduated: |
6 /
1963 |
| CME Year: |
2027 |
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Pending and/or Past Disciplinary Actions:
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| Date |
Action |
Reasons |
Remarks |
| 7/26/2018 |
License Reinstated |
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| 9/11/1987 |
Revoked License |
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Board Filings and/or Orders:
08/09/2018
09/11/1987
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All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
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| Certifications: |
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| New Patients: |
Yes |
| Medicaid: |
No |
| Medicare: |
Yes |
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| HMO/PPO: |
None listed |
| Hospital Privileges: |
None listed |
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