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Oklahoma Board of Medical Licensure and Supervision

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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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NAGASAWA, KELLY KAZUAKI       
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: 1923 S UTICA AVE 5TH FLOOR
TULSA OK 74104

Address last updated on 4/13/2024
Phone #: (918) 403-7054
Fax #:
County: TULSA
License: 34715
Dated: 5/14/2019
Expires: 5/1/2025
License Type: Medical Doctor
Specialty: Cardiothoracic Surgery
Surgical Oncology
SURGERY, THORACIC
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: NO
Medical School: UNIV OF HI J A BURNS SCH MED, HONOLULU HI 96822
Graduated: 5 / 2006
CME Year: 2025
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 THORACIC SURGERY
New Patients: Yes
Medicaid: Yes
Medicare: Yes
   
HMO/PPO: None listed
Hospital Privileges: Ascension St. John Medical Center
Tulsa, OK
Locations: Hours: Languages:
1923 S UTICA AVE 5TH FLOOR
TULSA OK 74104

Phone #: (918) 403-7054
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:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
VICKI LEIST APRN 83523
JAMIE SCOTT TEETER PA 2005
KYLE REID WERTZBERGER PA 2326

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