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Oklahoma Board of Medical Licensure and Supervision

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KITTREDGE, JOHN RUSSELL       
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: SAN XAVIER PHS
7900 S J STOCK RD
TUCSON AZ 85746
Phone #:
Fax #:
County: NOT OKLAHOMA
License: 12493
Dated: 9/25/1979
Expires: 6/30/1993
License Type: Medical Doctor
Specialty: Family Medicine
Status: Inactive
Status Class: Deceased
Restricted to:
Registered to Dispense: NO
Medical School: Albany Med Coll, Albany NY 12208
Graduated: 5 / 1976
CME Year:
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.
Certifications: AMERICAN BOARD OF FAMILY MEDICINE
New Patients: No
Medicaid: No
Medicare: No
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
SAN XAVIER PHS
7900 S J STOCK RD
TUCSON AZ 85746

Phone #:
Fax #:

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