COLSTON, ANNA CANOY - 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

COLSTON, ANNA CANOY

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:	VA MEDICAL CENTER 921 NE 13TH ST OKLAHOMA CITY OK 73104 Address last updated on 3/8/2024
Phone #:	(405) 456-3683
Fax #:
County:	OKLAHOMA
License:	2211
Dated:	2/12/2013
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:
VA MEDICAL CENTER 921 NE 13TH ST OKLAHOMA CITY OK 73104 Phone #: (405) 456-3683 Fax #:

Hospital Privileges:

None listed

Name:	Type:	License Number:
Primary Supervisor(s):
MUNAWAR ALI	MD	24167
NIRANJAN UDAYCHANDRA KAVADI	MD	30241
JOHN FULTON TOMPKINS II	MD	13837

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