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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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KRUCKENBERG, ERIN PAIGE       
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: US DERMATOLOGY PARTNERS
916 19TH ST
WOODWARD OK 73801

Address last updated on 3/2/2024
Phone #: (580) 377-3644
Fax #:
County: WOODWARD
License: 2828
Dated: 12/22/2017
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:
US DERMATOLOGY PARTNERS
916 19TH ST
WOODWARD OK 73801

Phone #: (580) 377-3644
Fax #:

Hospital Privileges:

None listed

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
THOMAS CARL HALL MD 22869

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