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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Sunday, December 22, 2024 6:44 PM CST
Next Update: Monday, December 23, 2024 2:50 AM CST

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CHESSMORE, KEVIN MICHAEL       
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: 3212 S.W. 89TH STREET SUITE 200
OKLAHOMA CITY OK 73159-7957

Address last updated on 8/6/2024
Phone #:
Fax #:
County: OKLAHOMA
License: 1576
Dated: 1/19/2007
Expires: 3/31/2025
Temp. Ltr. Issued: 1/18/2007
Temp. Ltr. Expires: 5/19/2007
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:
3212 S.W. 89TH STREET SUITE 200
OKLAHOMA CITY OK 73159-7957

Phone #:
Fax #:

Hospital Privileges:

None listed

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
JOEL WILLIAM ANDERSON III MD 16163
EDWARD RAYMOND ARMSTRONG MD 17271
CURTIS ERROL BALL DO 3932
HERSCHEL LAWRENCE BROWN MD 18034
SCOTT ALLEN CHAPPELL MD 24268
BRIAN COOK DO 3253
DATHAN DUANE JAY MD 23512
MICHAEL VON KALCICH MD 18986
KIM KING DO 2534
SANG LEE DO 3864
MICHAEL DAVID PADGHAM MD 17682
ANGELA L SELMON MD 17207
STEPHANIE JAYNE TOTH MD 25091

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