DIECKMANN, ANDREW KYLE - 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

DIECKMANN, ANDREW KYLE

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:	OKLAHOMA SPORTS ORTHOPEDIC INSTITUTE/SSM HEALTH 13401 N WESTERN AVE SUTIE 301 OKLAHOMA CITY OK 73114 Address last updated on 12/2/2024
Phone #:	(405) 218-2530
Fax #:
County:	OKLAHOMA
License:	1353
Dated:	1/26/2024
Expires:	8/31/2025
License Type:	Athletic Trainer
Specialty:

Status:	Active
Status Class:	Fully Licensed
Restricted to:
CME Year:	0

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:
OKLAHOMA SPORTS ORTHOPEDIC INSTITUTE/SSM HEALTH 13401 N WESTERN AVE SUTIE 301 OKLAHOMA CITY OK 73114 Phone #: (405) 218-2530 Fax #:

Name:	Type:	License Number:	Full/Part Time:
Primary Supervisor(s):
SEETHAL RAO MADHAVARAPU	MD	23053

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