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Next Update: Thursday, December 19, 2024 12:00 PM CST
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MUTHALALY, BOBBY KOSHY
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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.
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| Practice Address: |
2000 S WHEELING AVE STE 510
TULSA OK 74104-5642
Address last updated on 7/1/2024 |
| Phone #: |
(918) 747-5200 |
| Fax #: |
(918) 858-0290 |
| County: |
TULSA |
| License: |
20881 |
| Dated: |
8/28/1998 |
| Expires: |
8/1/2025 |
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Training
Issued:
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8/29/1996 |
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Training
Expires:
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8/1/1999 |
| License Type: |
Medical Doctor |
| Specialty: |
Nephrology |
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| Status: |
Active |
| Status Class: |
Fully Licensed |
| Restricted to: |
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| Registered to Dispense: |
NO |
| Medical School: |
Kasturba Med Coll Manipal, Manipal Acad Higher Ed, Manipal, Karnataka |
| Graduated: |
3 /
1983 |
| CME Year: |
2025 |
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Pending and/or Past Disciplinary Actions:
No Disciplinary Action Taken.
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All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
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| Certifications: |
AMERICAN BOARD OF INTERNAL MEDICINE - Nephrology |
| New Patients: |
Yes |
| Medicaid: |
Yes |
| Medicare: |
Yes |
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| HMO/PPO: |
Aetna HMO
Aetna Managed Choice
Aetna PPO
Blue Cross Blue Shield-Blue Preferred
Blue Cross Blue Shield-Blue Traditional
Blue Cross Blue Shield-Plan 65 Select
BlueChoice PPO
BlueLincs HMO
Champ VA
CIGNA HMO
CIGNA PPO
CommunityCare HMO, Inc
CommunityCare Senior HMO
CompMed
Coventry Health Care National Network
First Health
Global Health HMO
Great West Healthcare
HealthChoice
Humana ChoiceCare
Humana Medicare Advantage PPO
Humana Tricare/PGBA
Medicare Blue
Multiplan PPO
OSMA Health (formerly Plico PPO)
Pacificare Commercial HMO
PacifiCare of Oklahoma, Inc
PHCS (Private Healthcare Systems)
Preferred Community Choice
Private Healthcare Systems (PHCS)
Railroad Medicare
Secure Horizons HMO
SoonerCare HMO
SoonerCare PPO
Tricare for Life
Tricare Standard
United Healthcare Choice
United Healthcare EPO
United Healthcare HMO
United Healthcare Options PPO
United Healthcare POS |
| Hospital Privileges: |
Ascension St. John Jane Phillips Medical Center
Bartlesville, OK
Ascension St. John Medical Center
Tulsa, OK
Eastar Health System (fmly Muskogee Regional Med Ctr)
Muskogee, OK
Hillcrest Medical Center
Tulsa, OK
Hillcrest Specialty Hospital
Tulsa, OK
Kindred Hospital-Tulsa
Tulsa, OK
Select Specialty Hospital
Tulsa, OK
Solara Hospital
Muskogee, OK
St. Francis Hospital
Tulsa, OK
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