HOLLINGSWORTH, KYLE EVAN - Licensee Information

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Last Update: Wednesday, December 18, 2024 6:43 PM CST
Next Update: Thursday, December 19, 2024 2:50 AM CST

HOLLINGSWORTH, KYLE EVAN

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:	SOUTHWEST ORTHOPAEDIC & RECONSTRUCTIVE SPECIALISTS 1805 COMMONS CIRCLE STE. 100-C YUKON OK 73099 Address last updated on 11/18/2024
Phone #:	(405) 265-0165
Fax #:
County:	CANADIAN
License:	1341
Dated:	4/1/2004
Expires:	3/31/2025
Temp. Ltr. Issued:	1/15/2004
Temp. Ltr. Expires:	5/27/2004
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:
SOUTHWEST ORTHOPAEDIC & RECONSTRUCTIVE SPECIALISTS 1805 COMMONS CIRCLE STE. 100-C YUKON OK 73099 Phone #: (405) 265-0165 Fax #:

Hospital Privileges:

INTEGRIS Canadian Valley Regional Hospital
Yukon, OK
INTEGRIS Southwest Medical Center
Oklahoma City, OK
Oklahoma Center for Orthopaedic & Multi-Specialty Surgery
Oklahoma City, OK

Name:	Type:	License Number:
Primary Supervisor(s):
KRISTOPHER RYAN AVANT	DO	4499
STEVEN SANDS	DO	4331
Blake Stepanovich	DO	7190
ROBERT ARNOLD TODD JR	MD	24233

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