Oklahoma State SealOklahoma State Seal
Oklahoma Board of Medical Licensure and Supervision

Search Results

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

Return to Search Licensees page

BANKS, BRANDON LYNN       
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: ST JOHN MEDICAL CENTER
INTERVENTIONAL RADIOLOGY DEPARTMENT
1923 S UTICA AVE
TULSA OK 74104-5410

Address last updated on 2/13/2024
Phone #: (918) 744-2171
Fax #: (918) 744-3548
County: TULSA
License: 2175
Dated: 1/10/2013
Expires: 3/31/2025
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:
ST JOHN MEDICAL CENTER
INTERVENTIONAL RADIOLOGY DEPARTMENT
1923 S UTICA AVE
TULSA OK 74104-5410

Phone #: (918) 744-2171
Fax #: (918) 744-3548

Hospital Privileges:

Ascension St. John Medical Center
Tulsa, OK

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
MARK JOSEPH BALDECK MD 28100
Colby DeGiacomo DO 6641
Kari Hopfer DO 6676
Stephanie E. Kelly DO 3749
LARRY MATHIAS DO 7571
CORDELL LEE PRIVAT MD 30549
JESSICA WEBER DO 4585

Return to Search Licensees page