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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Thursday, December 19, 2024 3:44 AM CST
Next Update: Thursday, December 19, 2024 12:00 PM CST

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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.
Practice Address: 14400 BOGERT PKWY
STE. 100
OKLAHOMA CITY OK 73134

Address last updated on 12/8/2024
Phone #: (405) 302-1500
Fax #:
County: OKLAHOMA
License: 28890
Dated: 1/3/2012
Expires: 1/1/2026
License Type: Medical Doctor
Specialty: Family Medicine
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: YES
Medical School: Sun Yat-Sen Univ Of Med Sci, Guangzhou, China (242-21 Pr 1/71)
Graduated: 7 / 1990
CME Year: 2027
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 FAMILY MEDICINE
New Patients: Yes
Medicaid: No
Medicare: Yes
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
14400 BOGERT PKWY
STE. 100
OKLAHOMA CITY OK 73134

Phone #: (405) 302-1500
Fax #:
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:

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