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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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KHAMVANTHONG, PHONEKEO
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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: |
3517 W. OWEN K GARRIOTT ROAD
ENID OK 73703
Address last updated on 12/13/2024 |
| Phone #: |
(580) 233-5553 |
| Fax #: |
(580) 233-5641 |
| County: |
GARFIELD |
| License: |
37630 |
| Dated: |
1/11/2021 |
| Expires: |
1/1/2026 |
| License Type: |
Medical Doctor |
| Specialty: |
Family Medicine |
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| Status: |
Active |
| Status Class: |
Fully Licensed |
| Restricted to: |
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| Registered to Dispense: |
YES |
| Medical School: |
Ross Univ, Sch of Med, Roseau, Dominica |
| Graduated: |
3 /
2009 |
| CME Year: |
2027 |
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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 FAMILY MEDICINE |
| 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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