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

Search Results

Last Update: Thursday, December 19, 2024 3:44 AM CST
Next Update: Thursday, December 19, 2024 12:00 PM CST

Return to Search Licensees page

WINN, BENJAMIN KEITH       
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: KANSAS MEDICAL CLINIC
1261 E TULSA AVE
KANSAS OK 74347

Address last updated on 3/29/2024
Phone #: (918) 868-2175
Fax #:
County: DELAWARE
License: 4746
Dated: 2/8/2022
Expires: 3/31/2025
Temp. Ltr. Issued: 12/8/2021
Temp. Ltr. Expires: 3/10/2022
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:
KANSAS MEDICAL CLINIC
1261 E TULSA AVE
KANSAS OK 74347

Phone #: (918) 868-2175
Fax #:

Hospital Privileges:

None listed

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
DANIEL ALBERT PUMMILL MD 12734

Return to Search Licensees page