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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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YAMAGUCHI, IKUYO       
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: THE UNIVERSITY OF OKLAHOMA HEALTH SCIENCES CENTER
OKLAHOMA CHILDRENS HOSPITAL
1200 CHILDRENS AVE SUITE 14501
OKLAHOMA CITY OK 73104

Address last updated on 11/2/2024
Phone #: (405) 271-4409
Fax #: (405) 271-3967
County: OKLAHOMA
License: 37607
Dated: 1/11/2021
Expires: 1/1/2026
Temp. Lic. Issued: 12/8/2020
Temp. Lic. Expires: 1/21/2021
License Type: Medical Doctor
Specialty: Pediatric Nephrology
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: NO
Medical School: Kumamoto Univ Med Sch, Kumamoto, Japan
Graduated: 3 / 1987
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 PEDIATRICS - Pediatric Nephrology
New Patients: Yes
Medicaid: Yes
Medicare: Yes
   
HMO/PPO: None listed
Hospital Privileges: OU Health Medical Center
Oklahoma City, OK
Locations: Hours: Languages:
THE UNIVERSITY OF OKLAHOMA HEALTH SCIENCES CENTER
OKLAHOMA CHILDRENS HOSPITAL
1200 CHILDRENS AVE SUITE 14501
OKLAHOMA CITY OK 73104

Phone #: (405) 271-4409
Fax #: (405) 271-3967
Mon: 8:00AM - 4:30PM
Tue: 8:00AM - 4:30PM
Wed: 8:00AM - 4:30PM
Thu: 8:00AM - 4:30PM
Fri: 8:00AM - 4:30PM
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
BLAIR BLACKMAN APRN 20579
LAUREN TERRELL APRN 10150

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