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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Monday, December 23, 2024 3:49 AM CST
Next Update: Monday, December 23, 2024 12:00 PM CST

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KAMMERLOCHER, PAUL ALAN       
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: OK FOOT MD
3115 SW 89TH STREET
OKLAHOMA CITY OK 73159

Address last updated on 5/29/2024
Phone #: (405) 486-6900
Fax #: (405) 486-6839
County: OKLAHOMA
License: 17277
Dated: 7/1/1990
Expires: 7/1/2025
Training Issued: 6/22/1989
Training Expires: 9/30/1990
License Type: Medical Doctor
Specialty: Orthopedic Surgery
Foot and Ankle, Orthopedics
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: 5 / 1989
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 ORTHOPAEDIC SURGERY
New Patients: Yes
Medicaid: Contact licensee
Medicare: Yes
   
HMO/PPO: Beechstreet PPO
Blue Cross Blue Shield-Blue Traditional
BlueChoice PPO
Coventry Health Care National Network
HealthChoice
OSMA Health (formerly Plico PPO)
Preferred Community Choice
United Healthcare Options PPO
Hospital Privileges: Community Hospital - OKC
Oklahoma City, OK
McBride Orthopedic Hospital
Oklahoma City, OK
OU Health Medical Center
Oklahoma City, OK
Locations: Hours: Languages:
OK FOOT MD
3115 SW 89TH STREET
OKLAHOMA CITY OK 73159

Phone #: (405) 486-6900
Fax #: (405) 486-6839
Mon: 7:00AM - 6:00PM
Tue: 7:00AM - 6:00PM
Wed: 7:00AM - 6:00PM
Thu: 7:00AM - 6:00PM
Fri: 7:00AM - 6:00PM
Sat: 7:00AM - 6:00PM
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
RYAN BALLARD PA 2095
RALPH EUGENE FOUNTAIN PA 498
DAVID SHANNON HADDOCK PA 2055
SHAY DAWN HAYES PA 1041
AMBER DAWN HAYNES PA 1945
JOSEPH DAVON MARKEI HOSKINS PA 2285
STEPHEN MICHAEL ISERNHAGEN PA 2613
VICKI ELIZABETH JARRELL PA 1703
JOHN GILBERT MILLER PA 1187
KENDALL LEIGH PHILLIPS PA 1448
ALLYSON ANN PINKLEY PA 2184
BRETT DILLON PURVIS PA 1773
AMIR RAZA PA 1995
MICHAEL LYNN SANDERSON PA 1808
ANDREW BLAKE SMITH PA 2584
HEATHER PETERSON THOMPSON PA 2385
AARON CLAY WADE PA 866
AMY CHRISTINE WALKER PA 1419
JEFFREY SCOTT WALTER PA 1029

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