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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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BOMMASAMUDRAM, PAVANKUMAR       
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: REGIONAL BRAIN INSTITUTE
6120 YALE AVE
SUITE 1210
TULSA OK 74136-3573

Address last updated on 6/6/2024
Phone #: (918) 888-5211
Fax #: (918) 888-5270
County: TULSA
License: 27309
Dated: 7/1/2011
Expires: 7/1/2025
License Type: Medical Doctor
Specialty: Internal Medicine
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: NO
Medical School: Ross Univ, Sch of Med, Roseau, Dominica
Graduated: 5 / 2008
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: ABPS - Internal Medicine
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: Creek Nation Community Hospital
Okemah, OK
Eastern Oklahoma Medical Center
Poteau, OK
Hillcrest Hospital South (fmly SouthCrest)
Tulsa, OK
Hillcrest Medical Center
Tulsa, OK
Hospital(s) Not In Oklahoma
,
INTEGRIS Baptist Portland Ave (fmly Deaconess Hospital)
Oklahoma City, OK
INTEGRIS Canadian Valley Regional Hospital
Yukon, OK
INTEGRIS Health Ponca City Hospital -(frmly Via Christi)
Ponca City, OK
McAlester Regional Health Center
McAlester, OK
Northeastern Health System (formerly Tahlequah City Hospital)
Tahlequah, OK
OU Health Medical Center
Oklahoma City, OK
OU Medical Center - Edmond
Edmond, OK
SSM St Anthony Midwest Regional Medical Center
Midwest City, OK
Locations: Hours: Languages:
REGIONAL BRAIN INSTITUTE
6120 YALE AVE
SUITE 1210
TULSA OK 74136-3573

Phone #: (918) 888-5211
Fax #: (918) 888-5270
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
ALLISON RUSSELL BARTON PA 3161
BRETT JONATHAN BENNETT PA 999
RENHONG FRITTS PA 4884
ANGELA FAY PARKS PA 5290
KELSEA SEVERSON APRN 20015

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