THE FOLLOWING INFORMATION WAS OBTAINED FROM THE PHYSICIAN REGISTER SECTION OF THE WEBSITE OF THE COLLEGE OF PHYSICIANS AND SURGEONS OF ONTARIO (WWW.CPSO.ON.CA) AS OF THE DATE AND TIME NOTED BELOW
14/12/24 10:08:40 AM

General Information

Former Name: No Former Name
Medical School: Schulich School of Medicine and Dentistry, Western University, 1965
Gender: Man
Languages Spoken: ENGLISH

Practice Information

Primary Business Location: London Cardiac Institute
Suite 201
1055 Fanshawe Park Road West
London Ontario N6A 5P6
Business Email: No Information Available
Phone: (519) 645-0146
Fax: (519) 6451584

Specialties

SPECIALTY ISSUED ON CERTIFYING BODY
Internal Medicine
Effective: 16 Nov 1970
Royal College of Physicians and Surgeons of Canada
SPECIALTY: Internal Medicine
ISSUED ON: Effective: Nov 16 1970
CERTIFYING BODY: Royal College of Physicians and Surgeons of Canada

Hospital Privileges

HOSPITAL LOCATION
London Health Sciences Centre London
HOSPITAL: London Health Sciences Centre
LOCATION: London

Professional Corporation Information

Corporation Name: Derek Boughner Medicine Professional Corporation
Certificate of Authorization Status: Issued Date: 20 Aug 2012
Shareholders:
Dr. D. Boughner (CPSO#: 20960 )
Business Address: London Cardiac Institute
Suite 201
1055 Fanshawe Park Road West
London Ontario N6G 5B4
(519) 645-0146

General Information

Former Name: No Former Name
Gender: Man
Languages Spoken: ENGLISH
Medical School: Schulich School of Medicine and Dentistry, Western University, 1965

Practice Information

Primary Business Location: London Cardiac Institute
Suite 201
1055 Fanshawe Park Road West
London Ontario N6A 5P6
Business Email: No Information Available
Phone: (519) 645-0146
Fax: (519) 6451584

Specialties

SPECIALTY ISSUED ON CERTIFYING BODY
Internal Medicine
Effective: 16 Nov 1970
Royal College of Physicians and Surgeons of Canada
SPECIALTY: Internal Medicine
ISSUED ON: Effective: Nov 16 1970
CERTIFYING BODY: Royal College of Physicians and Surgeons of Canada

Hospital Privileges

HOSPITAL LOCATION
London Health Sciences Centre London
HOSPITAL: London Health Sciences Centre
LOCATION: London

Professional Corporation Information

Corporation Name: Derek Boughner Medicine Professional Corporation
Certificate of Authorization Status: Issued Date: 20 Aug 2012
Shareholders:
Dr. D. Boughner (CPSO#: 20960 )
Business Address: London Cardiac Institute
Suite 201
1055 Fanshawe Park Road West
London Ontario N6G 5B4
(519) 645-0146

Practice Conditions

VIEW DETAILS chevron-down icon
(1) Dr. DEREK RICHARD BOUGHNER may practise only in the areas of medicine in which Dr. BOUGHNER is educated and experienced.
VIEW DETAILS chevron-down icon
(1) Dr. DEREK RICHARD BOUGHNER may practise only in the areas of medicine in which Dr. BOUGHNER is educated and experienced.

Current Tribunal Proceedings

No information available

Past Tribunal Proceedings

No information available

Current Tribunal Proceedings

No information available

Past Tribunal Proceedings

No information available

Training

Medical School: Schulich School of Medicine and Dentistry, Western University, 1965

Registration History

DETAILS DATE
Transfer of class of registration to: Independent Practice Certificate Effective: 27 Jul 1967
First certificate of registration issued: Postgraduate Education Certificate Effective: 01 Jul 1965
DETAILS: Transfer of class of registration to: Independent Practice Certificate
Date: Effective: 27 Jul 1967

DETAILS: First certificate of registration issued: Postgraduate Education Certificate
Date: Effective: 01 Jul 1965