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Oklahoma Board of Medical Licensure and Supervision

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HAILEY, MICHAEL LUIS       
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: ST ANTHONY PHYSICIANS SHAWNEE
3315 KETHLEY
SHAWNEE OK 74802

Address last updated on 4/17/2020
Phone #: (405) 395-3821
Fax #:
County: POTTAWATOMIE
License: 3577
Dated: 8/1/2002
Expires: 10/12/2020
Temp. Ltr. Issued: 5/30/2002
Temp. Ltr. Expires: 9/21/2002
License Type: Physical Therapist
Specialty:
Status: Inactive
Status Class: Deceased
Restricted to:
CME Year: 2022
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:
ST ANTHONY PHYSICIANS SHAWNEE
3315 KETHLEY
SHAWNEE OK 74802

Phone #: (405) 395-3821
Fax #:

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