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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Thursday, December 26, 2024 6:44 PM CST
Next Update: Friday, December 27, 2024 2:50 AM CST

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BODENHAMER, ROBERT 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: 4050 W MEMORIAL ROAD
OKLAHOMA CITY OK 73120

Address last updated on 5/2/2022
Phone #: (405) 608-3927
Fax #: (405) 608-3838
County: OKLAHOMA
License: 12800
Dated: 7/10/1980
Expires: 7/1/2025
License Type: Medical Doctor
Specialty: SURGERY, CARDIOVASCULAR
Vascular Surgery
SURGERY, THORACIC
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of Ok Coll Of Med, Oklahoma City Ok 73190
Graduated: 6 / 1979
CME Year: 2027
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 THORACIC SURGERY
New Patients: Yes
Medicaid: Yes
Medicare: Yes
   
HMO/PPO: None listed
Hospital Privileges: Mercy Hospital OKC
Oklahoma City, OK
Oklahoma Heart Hospital - North Campus (4050 W. Memorial Rd)
Oklahoma City, OK
Oklahoma Heart Hospital - South Campus (5200 I-240 Service Rd)
Oklahoma City, OK
Locations: Hours: Languages:
4050 W MEMORIAL ROAD
OKLAHOMA CITY OK 73120

Phone #: (405) 608-3927
Fax #: (405) 608-3838
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
JORDYN CARLTON APRN 67
CHAD LEE NICHOLS PA 990
BRITTNEY JOLENE ROBERTS PA 2984
DARBI WILLIAMS APRN 110449

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