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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Thursday, April 25, 2024 7:02 PM CDT
Next Update: Friday, April 26, 2024 2:50 AM CDT

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KRUCKENBERG, ERIN PAIGE
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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