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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Monday, December 23, 2024 3:49 AM CST
Next Update: Monday, December 23, 2024 12:00 PM CST

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YERRA, VANAMA       
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: 901 NORTH PORTER AVENUE
NORMAN OK 73070

Address last updated on 4/30/2024
Phone #: (405) 307-1000
Fax #:
County: CLEVELAND
License: 22719
Dated: 3/4/2003
Expires: 3/1/2025
License Type: Medical Doctor
Specialty: Internal Medicine
Geriatric Medicine (Internal Medicine)
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: NO
Medical School: Andhra Med Coll, NTR Univ of Med Sci, Visakhapatnam, AP, India
Graduated: 12 / 1993
CME Year: 2027
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
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: Norman Regional Hospital
Norman, OK
Locations: Hours: Languages:
901 NORTH PORTER AVENUE
NORMAN OK 73070

Phone #: (405) 307-1000
Fax #:
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
KERI HOUCK APRN 89649
HILARY BROOKE MAHONEY PA 4469
JOHANNA NIROSHINI MOSES PA 2213
JORDAN ELISABETH SHUART PA 2853
RILLA KATHLEEN WALKER PA 1610

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