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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Friday, November 22, 2024 6:42 PM CST
Next Update: Saturday, November 23, 2024 2:50 AM CST

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KRUCKNER, DOUGLAS LEE       
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: 700 SUGAR CREEK DR.
HINTON OK 73047

Address last updated on 4/15/2024
Phone #:
Fax #:
County: CADDO
License: 39019
Dated: 5/12/2022
Expires: 5/1/2025
License Type: Medical Doctor
Specialty: Family Medicine
Status: Active
Status Class: Fully Licensed
Restricted to: AGREEMENT
Registered to Dispense: NO
Medical School: Rutgers Robt W Johnson Med Sch, (fmly UMDNJ)
Graduated: 5 / 2002
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:
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
700 SUGAR CREEK DR.
HINTON OK 73047

Phone #:
Fax #:
Mon: 7:00AM - 5:00PM
Tue: 7:00AM - 5:00PM
Wed: 7:00AM - 5:00PM
Thu: 7:00AM - 5:00PM
Fri:
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
ANDREA JULIA UZUEGBUNEM PA 2639

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