SLOBODOV, GENNADY - Licensee Information

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

SLOBODOV, GENNADY

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:	OU PHYSICIANS DEPT OF UROLOGY 825 N.E. 10TH SUITE 5F OKLAHOMA CITY OK 73104 Address last updated on 12/3/2024
Phone #:	(405) 271-6452
Fax #:	(405) 271-6219
County:	OKLAHOMA
License:	21955
Dated:	9/27/2001
Expires:	9/1/2025
License Type:	Medical Doctor
Specialty:	Urology

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 / 2000
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 UROLOGY AMERICAN BOARD OF UROLOGY - Female Pelvic Medicine and Reconstructive Surgery
New Patients:	Yes
Medicaid:	Yes
Medicare:	Yes

HMO/PPO:	Aetna Elect Choice 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 CIGNA PPO CommunityCare HMO, Inc Evolutions Healthcare First Health Health Smart Preferred Care (HSPC) HealthChoice Humana ChoiceCare PacifiCare of Oklahoma, Inc PPO USA Railroad Medicare Secure Horizons HMO United Healthcare Choice United Healthcare EPO United Healthcare HMO United Healthcare Options PPO United Healthcare POS
Hospital Privileges:	INTEGRIS Baptist Portland Ave (fmly Deaconess Hospital) Oklahoma City, OK OU Health - Edmond (frmrly Edmond Medical Center) Edmond, OK OU Health Medical Center Oklahoma City, OK V.A. Medical Center-OKC Oklahoma City, OK

Locations:	Hours:	Languages:
OU PHYSICIANS DEPT OF UROLOGY 825 N.E. 10TH SUITE 5F OKLAHOMA CITY OK 73104 Phone #: (405) 271-6452 Fax #: (405) 271-6219	Mon: 8:00AM - 5:00PM Tue: 8:00AM - 5:00PM Wed: 8:00AM - 5:00PM Thu: 8:00AM - 5:00PM Fri: 8:00AM - 5:00PM Sat: Sun:

Name:	Type:	License Number:
Primary Supervisees(s):
ASHLEY HEBENSPERGER	APRN	77299
JENNIFER LEWIS	APRN	84880

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