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Last Update: Saturday, December 21, 2024 3:49 AM CST
Next Update: Saturday, December 21, 2024 12:00 PM CST
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KASAL, JAN
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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.
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| Practice Address: |
MERCY VIRTUAL
15740 S OUTER FORTY RD
4TH FL
CHESTERFIELD MO 63017
Address last updated on 8/5/2021 |
| Phone #: |
(636) 237-4200 |
| Fax #: |
(314) 364-6382 |
| County: |
NOT OKLAHOMA |
| License: |
25314 |
| Dated: |
10/1/2006 |
| Expires: |
10/1/2022 |
| License Type: |
Medical Doctor |
| Specialty: |
Internal Medicine
Critical Care Medicine (Internal Medicine) |
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| Status: |
Inactive |
| Status Class: |
Expired License |
| Restricted to: |
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| Registered to Dispense: |
NO |
| Medical School: |
Univ Karlovy, Lek Fak I, Praha, Czech Rep |
| Graduated: |
5 /
1993 |
| CME Year: |
2024 |
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Pending and/or Past Disciplinary Actions:
No Disciplinary Action Taken.
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All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
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| Certifications: |
AMERICAN BOARD OF INTERNAL MEDICINE
AMERICAN BOARD OF INTERNAL MEDICINE - Critical Care Medicine |
| New Patients: |
Contact licensee |
| Medicaid: |
Contact licensee |
| Medicare: |
Contact licensee |
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| HMO/PPO: |
None listed |
| Hospital Privileges: |
Hospital(s) Not In Oklahoma
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Mercy Hospital OKC
Oklahoma City, OK
Mercy Memorial Health Center, Inc. - Ardmore
Ardmore, OK
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