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WOLLENHAUPT, KIMBERLY ROYSE       
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: JOHN KELLER PC MD
108 NORTH PARK
FAYETTEVILLE GA 30214

Address last updated on 2/20/2001
Phone #:
Fax #:
County: NOT OKLAHOMA
License: 19864
Dated: 7/16/1996
Expires: 7/1/2000
License Type: Medical Doctor
Specialty: Internal Medicine
Pediatrics
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of Md Sch Of Med, Baltimore Md 21201
Graduated: 6 / 1986
CME Year: 2000
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 INTERNAL MEDICINE
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:
JOHN KELLER PC MD
108 NORTH PARK
FAYETTEVILLE GA 30214

Phone #:
Fax #:

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