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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Thursday, December 19, 2024 3:44 AM CST
Next Update: Thursday, December 19, 2024 12:00 PM CST

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KIRK, KENNETH JOHN       
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: OKLAHOMA NEUROLOGIC INSTITUTE
6130 E 81ST ST
TULSA OK 74137

Address last updated on 6/20/2024
Phone #: (918) 401-1002
Fax #:
County: TULSA
License: 15217
Dated: 7/1/1985
Expires: 7/1/2025
License Type: Medical Doctor
Specialty: Internal Medicine
GERIATRICS
Pain Medicine
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: YES
Medical School: Univ Of Ok Coll Of Med, Oklahoma City Ok 73190
Graduated: 6 / 1984
CME Year: 2027
Pending and/or Past Disciplinary Actions:
Date Action Reasons Remarks
5/13/2021 License Reinstated
3/31/2017 Agreement
3/31/2017 Probation Ended
3/12/2015 Modification Order
11/7/2013 Modification Order
5/19/2011 Modification Order
8/18/2008 Probation
7/17/2008 Suspension, License
7/20/2006 Probation
5/5/2005 Revoked License
Board Filings and/or Orders:
04/05/2017
03/17/2015
11/15/2013
05/19/2011
07/17/2008
04/28/2008
04/28/2008
07/20/2006
05/11/2006
05/05/2005
12/09/2004
12/09/2004
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Certifications:
New Patients: Yes
Medicaid: Yes
Medicare: Yes
   
HMO/PPO: None listed
Hospital Privileges: Muscogee (Creek) Nation Medical Center (Okmulgee Mem. Hosp.)
Okmulgee, OK
Locations: Hours: Languages:
OKLAHOMA NEUROLOGIC INSTITUTE
6130 E 81ST ST
TULSA OK 74137

Phone #: (918) 401-1002
Fax #:
Mon: 8:30AM - 5:00PM
Tue: 8:30AM - 5:00PM
Wed: 8:30AM - 5:00PM
Thu: 8:30AM - 5:00PM
Fri: 8:30AM - 5:00PM
Sat:
Sun: 8:30AM - 5:00PM
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
ANDREA BUNCH APRN 111005
AMANDA DOANE APRN 14724

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