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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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MOCK, KYLE
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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: |
4200 S DOUGLAS AVE
STE 200B
OKLAHOMA CITY OK 73109
Address last updated on 6/28/2024 |
| Phone #: |
(405) 644-5447 |
| Fax #: |
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| County: |
OKLAHOMA |
| License: |
30009 |
| Dated: |
7/1/2014 |
| Expires: |
7/1/2025 |
| License Type: |
Medical Doctor |
| Specialty: |
Obstetrics & Gynecology |
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| Status: |
Active |
| Status Class: |
Fully Licensed |
| Restricted to: |
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| Registered to Dispense: |
NO |
| Medical School: |
Univ Of KS Sch Of Med, Kansas City Ks 66103 |
| Graduated: |
5 /
2013 |
| CME Year: |
2026 |
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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 OBSTETRICS AND GYNECOLOGY |
| New Patients: |
Yes |
| Medicaid: |
Yes |
| Medicare: |
Yes |
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| HMO/PPO: |
None listed |
| Hospital Privileges: |
SSM Health St. Anthony Hospital - OKC
Oklahoma City, OK
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