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Last Update: Wednesday, December 18, 2024 6:43 PM CST
Next Update: Thursday, December 19, 2024 2:50 AM CST
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BANAVALI, ASHTAMI VISHWANATH
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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: |
430 N. MONTE VISTA ST
ADA OK 74820
Address last updated on 9/9/2024 |
| Phone #: |
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| Fax #: |
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| County: |
PONTOTOC |
| License: |
32636 |
| Dated: |
11/22/2016 |
| Expires: |
11/1/2025 |
| License Type: |
Medical Doctor |
| Specialty: |
HEMATOLOGY/ONCOLOGY
Internal Medicine |
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| Status: |
Active |
| Status Class: |
Fully Licensed |
| Restricted to: |
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| Registered to Dispense: |
YES |
| Medical School: |
Topiwala Nat'L Med Coll, Univ Of Mumbai, Mumbai, Maharashtra, India |
| Graduated: |
3 /
2010 |
| CME Year: |
2025 |
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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 INTERNAL MEDICINE
AMERICAN BOARD OF INTERNAL MEDICINE - Hematology
AMERICAN BOARD OF INTERNAL MEDICINE - Oncology |
| New Patients: |
Contact licensee |
| Medicaid: |
Contact licensee |
| Medicare: |
Contact licensee |
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| HMO/PPO: |
None listed |
| Hospital Privileges: |
None listed |
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Primary Supervisees(s):
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| Name: |
Type: |
License Number: |
Full/Part Time: |
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KELLY SPYCHALSKI
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APRN |
14685 |
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