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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Wednesday, May 1, 2024 7:03 PM CDT
Next Update: Thursday, May 2, 2024 2:50 AM CDT

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MATHEW, JISS KANJIRAKATTU
Practice Address: 1000 N LEE
OKLAHOMA CITY OK 73102

Address last updated on 8/16/2023
Phone #: (405) 369-6515
Fax #: (405) 272-6075
County: OKLAHOMA
License: 28603
Dated: 7/30/2012
Expires: 7/1/2024
License Type: Medical Doctor
Specialty: Internal Medicine
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: YES
Medical School: Univ Of Ok Coll Of Med, Oklahoma City Ok 73190
Graduated: 5 / 2011
CME Year: 2024
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.
Certifications: AMERICAN BOARD OF INTERNAL MEDICINE
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: St. Anthony Hospital (SSM Health)
Oklahoma City, OK
Locations: Hours: Languages:
1000 N LEE
OKLAHOMA CITY OK 73102

Phone #: (405) 369-6515
Fax #: (405) 272-6075
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8913 NE 23rd St
Suite B
Oklahoma City, OK 73141

Phone #: (405) 259-9127
Fax #: (7) 202-
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Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
DEVORAH ANN ARCHER-WEBB PA 1107
LAUREN BERRY APRN 7601

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