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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Sunday, April 28, 2024 6:57 PM CDT
Next Update: Monday, April 29, 2024 2:50 AM CDT

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KOCH, TODD
Practice Address: OU HEALTH PHYSICIANS CANYON PARK FAMILY MEDICINE
1501 E 19TH STREET
EDMOND OK 73013

Address last updated on 2/1/2024
Phone #: (405) 348-6611
Fax #: (405) 348-9280
County: OKLAHOMA
License: 5067
Dated: 8/17/2023
Expires: 3/31/2025
Temp. Ltr. Issued: 6/27/2023
Temp. Ltr. Expires: 9/14/2023
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:
OU HEALTH PHYSICIANS CANYON PARK FAMILY MEDICINE
1501 E 19TH STREET
EDMOND OK 73013

Phone #: (405) 348-6611
Fax #: (405) 348-9280

Hospital Privileges:

None listed

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
ELIZABETH MICHEL NELSON MD 31582
FLOYD KEITH UNDERHILL MD 14384

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