BURNETT, KELSEY B - Licensee Information

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Last Update: Saturday, December 21, 2024 3:49 AM CST
Next Update: Saturday, December 21, 2024 12:00 PM CST

BURNETT, KELSEY B

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:	AMC URGENT CARE PLUS 2101 N. 14TH ST. SUITE 114 PONCA CITY OK 74601 Address last updated on 3/28/2024
Phone #:	(580) 762-1552
Fax #:
County:	KAY
License:	2382
Dated:	5/6/2014
Expires:	3/31/2025
Temp. Ltr. Issued:	2/27/2014
Temp. Ltr. Expires:	5/15/2014
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:
AMC URGENT CARE PLUS 2101 N. 14TH ST. SUITE 114 PONCA CITY OK 74601 Phone #: (580) 762-1552 Fax #:

Hospital Privileges:

None listed

Name:	Type:	License Number:
Primary Supervisor(s):
PAUL ANDREW BRIGGS	MD	20271
SAMUEL LYLE HAGUE	MD	22530

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