BERRY, KELLY JOHNSON - 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

BERRY, KELLY JOHNSON

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:	ASCENSION ST JOHN MEDICAL CENTER 1923 SOUTH UTICA AVE TULSA OK 74104-6502 Address last updated on 12/4/2023
Phone #:	(918) 744-2476
Fax #:	(918) 744-3075
County:	TULSA
License:	1968
Dated:	9/12/1992
Expires:	1/31/2025
License Type:	Physical Therapist
Specialty:

Status:	Active
Status Class:	Fully Licensed
Restricted to:
CME Year:	2026

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:
ASCENSION ST JOHN MEDICAL CENTER 1923 SOUTH UTICA AVE TULSA OK 74104-6502 Phone #: (918) 744-2476 Fax #: (918) 744-3075

Name:	Type:	License Number:
Primary Supervisees(s):
STACY A AVERY	TA	2588
WILLIAM GERALD BELLER	TA	2644

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