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KIELBASA, JOHANNA MARIE
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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: |
4502 E 41ST ST
TULSA OK 74135-2512
Address last updated on 5/4/2017 |
| Phone #: |
(918) 660-3401 |
| Fax #: |
(918) 660-3410 |
| County: |
TULSA |
| License: |
28708 |
| Dated: |
7/1/2011 |
| Expires: |
7/1/2018 |
| License Type: |
Medical Doctor |
| Specialty: |
Pediatrics |
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| Status: |
Inactive |
| Status Class: |
Expired License |
| Restricted to: |
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| Registered to Dispense: |
YES |
| Medical School: |
Wake Forest Univ Sch of Med, Winston-Salem, NC 27157 |
| Graduated: |
5 /
2007 |
| CME Year: |
2020 |
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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 PEDIATRICS |
| New Patients: |
Yes |
| Medicaid: |
Yes |
| Medicare: |
Yes |
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| HMO/PPO: |
None listed |
| Hospital Privileges: |
St. Francis Hospital
Tulsa, OK
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