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Oklahoma Board of Medical Licensure and Supervision

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BOGART, KIMBERLY RAGENA       
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: THE PRIMARY CARE GROUP OF OKLAHOMA
9001 SOUTH 101ST EAST AVE SUITE 350
TULSA OK 74133

Address last updated on 2/20/2007
Phone #: (918) 392-5500
Fax #:
County: TULSA
License: 1124
Dated: 4/1/2001
Expires: 3/31/2009
Temp. Ltr. Issued: 2/16/2001
Temp. Ltr. Expires: 3/31/2001
License Type: Physician Assistant
Specialty:
Status: Inactive
Status Class: Expired License
Restricted to:
CME Year:
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:
THE PRIMARY CARE GROUP OF OKLAHOMA
9001 SOUTH 101ST EAST AVE SUITE 350
TULSA OK 74133

Phone #: (918) 392-5500
Fax #:

Hospital Privileges:

None listed

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