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Oklahoma Board of Medical Licensure and Supervision

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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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HART, PAUL LAWRENCE       
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: KIDNEY SPECIALIST OF CENTRAL OKLAHOMA
3366 NW EXPRESSWAY BLDG-D STE 550
OKLAHOMA CITY OK 73112-4489

Address last updated on 3/29/2024
Phone #: (405) 942-5442
Fax #:
County: OKLAHOMA
License: 2007
Dated: 5/6/2011
Expires: 3/31/2025
Temp. Ltr. Issued: 4/8/2011
Temp. Ltr. Expires: 5/20/2011
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:
KIDNEY SPECIALIST OF CENTRAL OKLAHOMA
3366 NW EXPRESSWAY BLDG-D STE 550
OKLAHOMA CITY OK 73112-4489

Phone #: (405) 942-5442
Fax #:

Hospital Privileges:

INTEGRIS Baptist Medical Center
Oklahoma City, OK
INTEGRIS Baptist Portland Ave (fmly Deaconess Hospital)
Oklahoma City, OK
INTEGRIS Canadian Valley Regional Hospital
Yukon, OK
INTEGRIS Edmond
Edmond, OK
INTEGRIS Southwest Medical Center
Oklahoma City, OK
Select Specialty Hospital-OKC
Oklahoma City, OK

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
ALY M.ELSEBAI ALY MD 19742
SHEHZAD JAFFER BANDHANI MD 29134
ANGELA DENE' BOLZ DO 4505
GARY DEAN BOND MD 16974
BRADLEY DEAN CARTER MD 21578
LAXMI NARAYANA RAO GADDE MD 25313
JAWAID AHMED JAMAL MD 24582
MANSOOR KHALID MD 25798
SUDHIR KUMAR KHANNA MD 18130
BRADLEY THOMAS LONG MD 34999
GURUPRASAD MANJUNATH MD 27494
SUJAN PATHAK MD 32023
LAURA ISAACS RANKIN MD 12786
MAMOON RASHEED MD 31845
PATRICK BRONSON REEVES MD 34129
DAVID THOMPSON DO 4033

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