Oklahoma State SealOklahoma State Seal
Oklahoma Board of Medical Licensure and Supervision

Search Results

Last Update: Sunday, December 22, 2024 6:44 PM CST
Next Update: Monday, December 23, 2024 2:50 AM CST

Return to Search Licensees page

CALDWELL, CONRAD C III       
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: VA MEDICAL CENTER
921 NE 13TH STREET
OKLAHOMA CITY OK 73104

Address last updated on 4/1/2024
Phone #: (405) 456-5421
Fax #:
County: OKLAHOMA
License: 22805
Dated: 5/9/2002
Expires: 5/1/2025
License Type: Medical Doctor
Specialty: Emergency Medicine
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 / 1999
CME Year: 2026
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 EMERGENCY MEDICINE
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: SSM Health St. Anthony Hospital - OKC
Oklahoma City, OK
V.A. Medical Center-OKC
Oklahoma City, OK
Locations: Hours: Languages:
VA MEDICAL CENTER
921 NE 13TH STREET
OKLAHOMA CITY OK 73104

Phone #: (405) 456-5421
Fax #:
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
STEPHANIE VAN-ANH BADAROUX PA 2885
MATTHEW STEVEN BERTUS PA 861
DONNA BLACH APRN 42209
RANDALL ALLEN CARTER PA 1045
BRENT MICHAEL DAVIS PA 2052
MONICA ESPARZA APRN 47426
JAMES CAMERON HOGAN PA 1816
SCOTT RANDALL INTERWICZ PA 2304
SASA KOREN JACKSON PA 2107
FARZANA JAHANGIR PA 2494
CHRISTOPHER TODD JAMES PA 1231
ROBERT WILLIAM KELLINGTON II PA 2458
TIM MICHAEL LAING PA 792
KATHLEEN ELLEN MASON-MORTON PA 964
AMY ELIZABETH POTTS PA 3055
JACK BRADLEY SMITH PA 1155
KATHRYN WALENZ PA 2588
RACHEL WITMER PA 2655

Return to Search Licensees page