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Oklahoma Board of Medical Licensure and Supervision

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ISHAM, PHILLIP LEONARD       
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: 1004 EAST BRYAN
SAPULPA OK 74066

Address last updated on 12/23/1999
Phone #:
Fax #:
County: CREEK
License: 9683
Dated: 6/30/1972
Expires: 12/28/2000
License Type: Medical Doctor
Specialty: Family Medicine
Anesthesiology
Emergency Medicine
Status: Inactive
Status Class: Deceased
Restricted to:
Registered to Dispense: YES
Medical School: Univ Of Ok Coll Of Med, Oklahoma City Ok 73190
Graduated: / 1971
CME Year: 2001
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:
1004 EAST BRYAN
SAPULPA OK 74066

Phone #:
Fax #:

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