KUYKENDALL, TRACY DEE - 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

KUYKENDALL, TRACY DEE

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:	1218 E 9TH STREET SUITE 1 EDMOND OK 73034 Address last updated on 8/2/2024
Phone #:	(405) 301-8010
Fax #:	(888) 720-0860
County:	OKLAHOMA
License:	23494
Dated:	9/21/2004
Expires:	9/1/2025
License Type:	Medical Doctor
Specialty:	Dermatology

Status:	Active
Status Class:	Fully Licensed
Restricted to:
Registered to Dispense:	YES
Medical School:	Univ Of AR Coll Of Med, Little Rock AR 72205
Graduated:	5 / 2003
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 DERMATOLOGY
New Patients:	Yes
Medicaid:	No
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 HMO CIGNA PPO CommunityCare HMO, Inc Coventry Health Care National Network First Health HealthChoice Humana ChoiceCare Humana Medicare Advantage PPO Humana Tricare/PGBA Pacificare Commercial HMO PacifiCare of Oklahoma, Inc Preferred Community Choice Tricare for Life Tricare Standard United Healthcare Choice United Healthcare EPO United Healthcare Options PPO United Healthcare POS
Hospital Privileges:	Hillcrest Hospital South (fmly SouthCrest) Tulsa, OK Hillcrest Medical Center Tulsa, OK

Locations:	Hours:	Languages:
1218 E 9TH STREET SUITE 1 EDMOND OK 73034 Phone #: (405) 301-8010 Fax #: (888) 720-0860	Mon: Tue: Wed: Thu: Fri: Sat: Sun:
3308 NW 135th suite 100 Oklahoma City, OK 73120 Phone #: (405) 807-6265 Fax #: (2) 202-	Mon: 8:00AM - 5:00PM Tue: 10:00AM - 7:00PM Wed: 8:00AM - 5:00PM Thu: 8:00AM - 5:00PM Fri: 8:00AM - 12:00PM Sat: Sun:
BeautyRx Oklahoma 1123 Main Street Woodward, OK 73801 Phone #: (405) 203-7307 Fax #: (3) 202-	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):
JADE DUNN	APRN	95549
KASEY LEIGH SWAYDEN	PA	2139

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