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WARREN, KELLY JOHN       
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: EPIPHANY DERMATOLOGY
4724 WELLINGTON STREET
GREENVILLE TX 75401-4944

Address last updated on 2/7/2018
Phone #: (214) 335-0505
Fax #:
County: NOT OKLAHOMA
License: 28758
Dated: 11/9/2011
Expires: 11/1/2012
License Type: Medical Doctor
Specialty: Dermatology
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: Columbia Univ Coll Of Physicians And Surgeons, New York Ny 10032
Graduated: 5 / 1995
CME Year: 2014
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 DERMATOLOGY
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
EPIPHANY DERMATOLOGY
4724 WELLINGTON STREET
GREENVILLE TX 75401-4944

Phone #: (214) 335-0505
Fax #:
Mon: 8:00AM - 5:00PM
Tue: 8:00AM - 5:00PM
Wed: 8:00AM - 5:00PM
Thu: 8:00AM - 5:00PM
Fri: 8:00AM - 5:00PM
Sat:
Sun:

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