GALLIMORE, COLLEEN LYNN - Licensee Information

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Last Update: Wednesday, December 18, 2024 6:43 PM CST
Next Update: Thursday, December 19, 2024 2:50 AM CST

GALLIMORE, COLLEEN LYNN

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:	MMG CARDIOVASCULAR & THORACIC SURGERY 3201 W GORE BLVD SUITE G2 LAWTON OK 73505 Address last updated on 11/22/2024
Phone #:	(580) 357-4339
Fax #:	(580) 357-4423
County:	COMANCHE
License:	1505
Dated:	4/1/2006
Expires:	3/31/2025
Temp. Ltr. Issued:	12/22/2005
Temp. Ltr. Expires:	5/13/2006
License Type:	Physician Assistant
Specialty:

Status:	Active
Status Class:	Fully Licensed
Restricted to:
CME Year:	2025

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.

Locations:	Hours:	Languages:
MMG CARDIOVASCULAR & THORACIC SURGERY 3201 W GORE BLVD SUITE G2 LAWTON OK 73505 Phone #: (580) 357-4339 Fax #: (580) 357-4423

Hospital Privileges:

Comanche County Memorial Hospital
Lawton, OK

Name:	Type:	License Number:
Primary Supervisor(s):
ROBERTO DE ALBA CERVERA	MD	34162
GEORGE MICHAEL COMAS	MD	34253
LEE DOUGLASS ROBERSON	MDC	43521
AARON LEE TRACHTE	MD	20331

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