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Oklahoma Board of Medical Licensure and Supervision

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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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GREEN, INA KIM       
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: 14400 BOGERT PARKWAY
SUITE 100
OKLAHOMA CITY OK 73134-2653

Address last updated on 3/10/2024
Phone #: (405) 302-1500
Fax #:
County: OKLAHOMA
License: 1010
Dated: 3/8/2000
Expires: 3/31/2025
Temp. Ltr. Issued: 12/30/1999
Temp. Ltr. Expires: 3/11/2000
License Type: Physician Assistant
Specialty:
Status: Active
Status Class: Fully Licensed
Restricted to:
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.
Locations: Hours: Languages:
14400 BOGERT PARKWAY
SUITE 100
OKLAHOMA CITY OK 73134-2653

Phone #: (405) 302-1500
Fax #:

Hospital Privileges:

V.A. Medical Center-OKC
Oklahoma City, OK

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