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

Search Results

Last Update: Friday, November 22, 2024 1:58 PM CST
Next Update: Friday, November 22, 2024 4:30 PM CST

Return to Search Licensees page

RICHARDSON, TIMOTHY J       
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: OKLAHOMA CITY VA MEDICAL CENTER
921 NE 13TH STREET
OKLAHOMA CITY OK 73014-5007

Address last updated on 5/13/2024
Phone #: (405) 456-1000 x3742
Fax #:
County: OKLAHOMA
License: 4699
Dated: 11/2/2021
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:
OKLAHOMA CITY VA MEDICAL CENTER
921 NE 13TH STREET
OKLAHOMA CITY OK 73014-5007

Phone #: (405) 456-1000 x3742
Fax #:

Hospital Privileges:

None listed

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
JEAN I. KEDDISSI MD 20091

Return to Search Licensees page