CHAMPLIN, KEITH EDWARDS - Licensee Information

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Last Update: Monday, November 4, 2024 1:08 PM CST
Next Update: Monday, November 4, 2024 4:30 PM CST

CHAMPLIN, KEITH EDWARDS

Practice Address:	ST. FRANCIS TRAUMA INSTITUTE 6161 S. YALE AVE. LEVEL B TULSA OK 74136 Address last updated on 7/9/2024
Phone #:	(918) 494-6980
Fax #:
County:	TULSA
License:	39882
Dated:	8/22/2022
Expires:	8/1/2025
Temp. Lic. Issued:	7/22/2022
Temp. Lic. Expires:	9/15/2022
License Type:	Medical Doctor
Specialty:	Trauma Surgery

Status:	Active
Status Class:	Fully Licensed
Restricted to:
Registered to Dispense:	NO
Medical School:	Univ Of Ok Coll Of Med, Oklahoma City Ok 73190
Graduated:	5 / 2015
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 SURGERY AMERICAN BOARD OF SURGERY (Surgery specific) - Surgical Critical Care
New Patients:	Contact licensee
Medicaid:	Contact licensee
Medicare:	Contact licensee

HMO/PPO:	None listed
Hospital Privileges:	None listed

Locations:	Hours:	Languages:
ST. FRANCIS TRAUMA INSTITUTE 6161 S. YALE AVE. LEVEL B TULSA OK 74136 Phone #: (918) 494-6980 Fax #:	Mon: Tue: Wed: Thu: Fri: Sat: Sun:

Name:	Type:	License Number:
Primary Supervisees(s):
JAYNE ELIZABETH CONTRERAS	PA	2103
DANIEL MACK HUNT	PA	5042
JOHN MICHAEL NEISEN	PA	4613