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Next Update: Thursday, December 19, 2024 2:50 AM CST
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IPPOLITO, MARK RICHARD
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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: |
UNITED HEALTHCARE
PO BOX 9472
MINNEAPOLIS MN 55440-9472
Address last updated on 7/15/2024 |
| Phone #: |
(952) 251-1086 |
| Fax #: |
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| County: |
NOT OKLAHOMA |
| License: |
38395 |
| Dated: |
8/30/2021 |
| Expires: |
8/1/2025 |
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Temp.
Lic.
Issued:
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8/6/2021 |
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Temp.
Lic.
Expires:
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9/16/2021 |
| License Type: |
Medical Doctor |
| Specialty: |
Neurology
Clinical Neurophysiology
Sleep Medicine |
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| Status: |
Active |
| Status Class: |
Fully Licensed |
| Restricted to: |
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| Registered to Dispense: |
NO |
| Medical School: |
Univ at Buffalo Sch of Med and Biomedical Sci, SUNY, Buffalo, NY |
| Graduated: |
6 /
1992 |
| 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 INTERNAL MEDICINE - Sleep Medicine
AMERICAN BOARD OF PSYCHIATRY AND NEUROLOGY - Clinical Neurophysiology
AMERICAN BOARD OF PSYCHIATRY AND NEUROLOGY (Neurology specific) |
| 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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