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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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HACKER, KELLY JO       
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: INTEGRIS BAPTIST MEDICAL CENTER
3344 N.W. 56TH ST. BLDG B SU. 660
OKLAHOMA CITY OK 73112

Address last updated on 3/25/2024
Phone #: (405) 951-2277
Fax #:
County: OKLAHOMA
License: 1373
Dated: 9/1/2004
Expires: 3/31/2025
Temp. Ltr. Issued: 10/1/2012
Temp. Ltr. Expires: 11/9/2012
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:
INTEGRIS BAPTIST MEDICAL CENTER
3344 N.W. 56TH ST. BLDG B SU. 660
OKLAHOMA CITY OK 73112

Phone #: (405) 951-2277
Fax #:

Hospital Privileges:

INTEGRIS Baptist Medical Center
Oklahoma City, OK

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
JEFFREY MICHAEL ASBURY MD 21211
GEORGE STEVEN CHRYSANT MD 23804
BRYAN DEAN COGAR MD 26038
WILLIAM LANCE GARNER MD 26970
SEAN MICHAEL HALLERAN MD 29644
JEFFREY MICHAEL SPARLING MD 23000

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