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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Friday, November 22, 2024 6:42 PM CST
Next Update: Saturday, November 23, 2024 2:50 AM CST

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NIEBERGALL, ROBERT GERALD       
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: 800 WEST BOISE CIRCLE
BROKEN ARROW OK 74102

Address last updated on 4/2/2024
Phone #: (918) 994-9160
Fax #: (918) 293-3169
County: TULSA
License: 13607
Dated: 5/17/1982
Expires: 5/1/2025
License Type: Medical Doctor
Specialty: Internal Medicine
GERIATRICS
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: YES
Medical School: Univ Auto De Guadalajara, Fac De Med, Guadalajara, Jalisco, Mexico
Graduated: 6 / 1978
CME Year: 2025
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:
New Patients: Yes
Medicaid: No
Medicare: Yes
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
800 WEST BOISE CIRCLE
BROKEN ARROW OK 74102

Phone #: (918) 994-9160
Fax #: (918) 293-3169
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
ANTHONY NICHOLAS BARBETTINI PA 1347
ERIN MARIE CAPPS PA 2074
KAYLYNN COATS ELMORE PA 1953
MEGAN BLAIRE KASSEM PA 2881
KELSEY NICOLE KLEIN PA 2391
JENNIFER RENEE MEANS PA 2084
CORINNE ONIGBINDE PA 2873
KARLEE CAMPBELL VAN DAM PA 3137

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