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Oklahoma Board of Medical Licensure and Supervision

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BENNETT, KEITH GAGE       
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: 16101 BRENNER PASS
EDMOND OK 73013
Phone #:
Fax #:
County: OKLAHOMA
License: 15102
Dated: 7/1/1985
Expires: 6/30/1994
License Type: Medical Doctor
Specialty: General Surgery
Plastic Surgery
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of AR Coll Of Med, Little Rock AR 72205
Graduated: 5 / 1984
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 SURGERY
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
16101 BRENNER PASS
EDMOND OK 73013

Phone #:
Fax #:

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