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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Saturday, December 21, 2024 3:49 AM CST
Next Update: Saturday, December 21, 2024 12:00 PM CST

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BRAUD, KRISTA BAINE       
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: 4 R FAMILIES MEDICAL CLINIC
721 W. BROADWAY
SUITE C
ENID OK 73701

Address last updated on 9/24/2024
Phone #: (580) 297-5340
Fax #: (580) 297-5344
County: GARFIELD
License: 1259
Dated: 4/1/2003
Expires: 3/31/2025
Temp. Ltr. Issued: 1/16/2003
Temp. Ltr. Expires: 3/31/2003
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:
4 R FAMILIES MEDICAL CLINIC
721 W. BROADWAY
SUITE C
ENID OK 73701

Phone #: (580) 297-5340
Fax #: (580) 297-5344

Hospital Privileges:

None listed

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
MICHAEL LAWRENCE DO 4206
JAMES MICHAEL PONTIOUS MD 12733
MARGO RENEE SHORT MD 23498
FARSHID ADAM-AMIR ZANDI MD 22558

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