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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Thursday, May 2, 2024 5:08 PM CDT
Next Update: Friday, May 3, 2024 2:50 AM CDT

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DIECKMANN, ANDREW KYLE
Practice Address: OKLAHOMA SPORTS ORTHOPEDIC INSTITUTE/SSM HEALTH
13401 N WESTERN AVE SUTIE 301
OKLAHOMA CITY OK 73114

Address last updated on 2/1/2024
Phone #: (405) 218-2530
Fax #:
County: OKLAHOMA
License: 1353
Dated: 1/26/2024
Expires: 8/31/2024
License Type: Athletic Trainer
Specialty:
Status: Active
Status Class: Fully Licensed
Restricted to:
CME Year: 0
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:
OKLAHOMA SPORTS ORTHOPEDIC INSTITUTE/SSM HEALTH
13401 N WESTERN AVE SUTIE 301
OKLAHOMA CITY OK 73114

Phone #: (405) 218-2530
Fax #:
Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
SEETHAL RAO MADHAVARAPU MD 23053

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