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MILLER, KIMBALL AUSTIN       
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: CMO/MERCY HEALTH PLANS INC
12935 NORTH OUTHER 40 DRIVE
ST LOUIS MO 63141-8636
Phone #:
Fax #:
County: NOT OKLAHOMA
License: 14657
Dated: 5/21/1984
Expires: 5/1/1996
License Type: Medical Doctor
Specialty: Adolescent Medicine (Pediatrics)
Pediatrics
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of Mi Med Sch, Ann Arbor Mi 48109
Graduated: 6 / 1975
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 PEDIATRICS
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
CMO/MERCY HEALTH PLANS INC
12935 NORTH OUTHER 40 DRIVE
ST LOUIS MO 63141-8636

Phone #:
Fax #:

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