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KEDDISSI, JEAN I.       
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: 800 STANTON L. YOUNG BLVD
SUITE 8400
OKLAHOMA CITY OK 73104

Address last updated on 1/30/2023
Phone #: (405) 271-6173
Fax #: (405) 271-5892
County: OKLAHOMA
License: 20091
Dated: 3/7/1997
Expires: 3/1/2025
License Type: Medical Doctor
Specialty: Critical Care Medicine (Internal Medicine)
Pulmonary Disease
Internal Medicine
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: NO
Medical School: St Joseph's Univ, Fac Of Med, Beirut, Lebanon
Graduated: 6 / 1993
CME Year: 2025
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 - Critical Care Medicine
AMERICAN BOARD OF INTERNAL MEDICINE - Pulmonary Disease
New Patients: Yes
Medicaid: Yes
Medicare: Yes
   
HMO/PPO: None listed
Hospital Privileges: OU Health Medical Center
Oklahoma City, OK
V.A. Medical Center-OKC
Oklahoma City, OK
Locations: Hours: Languages:
800 STANTON L. YOUNG BLVD
SUITE 8400
OKLAHOMA CITY OK 73104

Phone #: (405) 271-6173
Fax #: (405) 271-5892
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
ERIN MARBURGER APRN 91124
NICOLE MARIE MASSIE PA 2727
KATHARINE IMPELLITIER PENTECOST PA 2343
TIMOTHY J RICHARDSON PA 4699
ANDREW WONG PA 3079
JINCY YOHANNAN PA 2571

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