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Last Update: Wednesday, December 18, 2024 6:43 PM CST
Next Update: Thursday, December 19, 2024 2:50 AM CST

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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: OKLAHOMA UNIVERSITY HSC DEPT OF UROLOGY
920 STANTON L YOUNG BLVD WP 3150
OKLAHOMA CITY OK 73104

Address last updated on 6/30/2019
Phone #: (405) 271-6900
Fax #:
County: OKLAHOMA
License: 24443
Dated: 6/9/2005
Expires: 6/1/2021
License Type: Medical Doctor
Specialty: Urology
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of TX Southwestern Med Sch At Dallas SW Med Sch, Dallas Tx 75235
Graduated: 6 / 2000
CME Year: 2023
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
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: INTEGRIS Baptist Medical Center
Oklahoma City, OK
OU Health Medical Center
Oklahoma City, OK
SSM Health St. Anthony Hospital - OKC
Oklahoma City, OK
SSM St Anthony Midwest Regional Medical Center
Midwest City, OK
V.A. Medical Center-OKC
Oklahoma City, OK
Locations: Hours: Languages:
OKLAHOMA UNIVERSITY HSC DEPT OF UROLOGY
920 STANTON L YOUNG BLVD WP 3150
OKLAHOMA CITY OK 73104

Phone #: (405) 271-6900
Fax #:
Mon:
Tue:
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