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Oklahoma Board of Medical Licensure and Supervision

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CRUIKSHANK, ROBERT WENDELL       
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: 7600 S LEWIS AVE
TULSA OK 74136

Address last updated on 6/6/2003
Phone #: (918) 493-7800
Fax #:
County: TULSA
License: 22474
Dated: 8/7/2002
Expires: 8/1/2005
License Type: Medical Doctor
Specialty: Family Medicine
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: YES
Medical School: SUNY Upstate Med Univ, Syracuse, NY 13210
Graduated: 5 / 2001
CME Year: 2005
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:
New Patients: No
Medicaid: Yes
Medicare: Yes
   
HMO/PPO: Aetna HMO
Aetna PPO
BlueChoice PPO
BlueLincs HMO
CommunityCare HMO, Inc
HealthChoice
Heartland Health Plan of Oklahoma
PacifiCare of Oklahoma, Inc
United Healthcare HMO
United Healthcare Options PPO
Hospital Privileges: None listed
Locations: Hours: Languages:
7600 S LEWIS AVE
TULSA OK 74136

Phone #: (918) 493-7800
Fax #:

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