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SHIDELER, ANDREW MARK       
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: WILLOW PARK HEALTH CARE CENTER
7019 NW CACHE ROAD
LAWTON OK 73505

Address last updated on 4/12/2013
Phone #: (580) 510-3158
Fax #:
County: COMANCHE
License: 4388
Dated: 8/20/2010
Expires: 1/31/2014
License Type: Physical Therapist
Specialty:
Status: Inactive
Status Class: Expired License
Restricted to:
CME Year: 2016
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:
WILLOW PARK HEALTH CARE CENTER
7019 NW CACHE ROAD
LAWTON OK 73505

Phone #: (580) 510-3158
Fax #:

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