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CAUDILL, BRENT KIMBRELL       
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: PREVENTIVE HEALTHCARE LLC
201 NORTH JEFFERSON STREET #D
ST. JAMES MO 65559

Address last updated on 4/25/2013
Phone #: (573) 265-0911
Fax #:
County: NOT OKLAHOMA
License: 28976
Dated: 5/1/2012
Expires: 5/1/2014
License Type: Medical Doctor
Specialty: General Practice
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: IN Univ Sch Of Med, Indianapolis In 46202
Graduated: 5 / 1979
CME Year: 2015
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:
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
PREVENTIVE HEALTHCARE LLC
201 NORTH JEFFERSON STREET #D
ST. JAMES MO 65559

Phone #: (573) 265-0911
Fax #:

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