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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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IVANOV, VADIM ANATOLYEVICH       
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: SECTION OF NEONATAL-PERINATAL MEDICINE
UNIVERSITY OF OKLAHOMA HEALTH SCIENCES CENTER
1200 N EVERETT DR.
OKLAHOMA CITY OK 73104-5047

Address last updated on 12/19/2022
Phone #: (405) 271-5215
Fax #:
County: OKLAHOMA
License: 27513
Dated: 1/12/2010
Expires: 1/1/2025
License Type: Medical Doctor
Specialty: Pediatrics
Neonatal-Perinatal Medicine
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: NO
Medical School: Russian State Med Univ (Second Moscow Med Inst), Moscow, Russia
Graduated: 5 / 1987
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 PEDIATRICS
AMERICAN BOARD OF PEDIATRICS - Neonatal-Perinatal Medicine
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: Comanche County Memorial Hospital
Lawton, OK
OU Health Medical Center
Oklahoma City, OK
Locations: Hours: Languages:
SECTION OF NEONATAL-PERINATAL MEDICINE
UNIVERSITY OF OKLAHOMA HEALTH SCIENCES CENTER
1200 N EVERETT DR.
OKLAHOMA CITY OK 73104-5047

Phone #: (405) 271-5215
Fax #:
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3401 W Gore Blvd
Lawton, OK 73505

Phone #: (580) 355-8620
Fax #: (12) 201-
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Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
MACIE CAINES APRN 1786
JENNIFER MILAM APRN 71993
CRISTY TRUSKETT APRN 1659

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