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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Friday, November 22, 2024 8:19 AM CST
Next Update: Friday, November 22, 2024 12:00 PM CST

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JOHNSON, NICHOLAS ROBERT       
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: 9800 BROADWAY EXT SUITE 201
OKLAHOMA CITY OK 73114

Address last updated on 10/25/2024
Phone #:
Fax #:
County: OKLAHOMA
License: 42429
Dated: 12/8/2023
Expires: 12/1/2025
License Type: Medical Doctor
Specialty: Orthopedic 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 / 2018
CME Year: 2026
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:
9800 BROADWAY EXT SUITE 201
OKLAHOMA CITY OK 73114

Phone #:
Fax #:
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
LLOYD SCOTT DUNKLEBERGER PA 939
KRISTY MARIE OLIVO PA 2648
RANDALL ASHLEY PAPE PA 1481

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