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Last Update: Monday, December 23, 2024 1:13 PM CST
Next Update: Monday, December 23, 2024 4:30 PM CST

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MAZZIOTTI, MARK VICTOR       
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: INTEGRIS BAPTIST MEDICAL CENTER
3300 NW EXPRESSWAY
MWT 1210
OKLAHOMA CITY OK 73112

Address last updated on 3/22/2024
Phone #: (405) 949-3011
Fax #:
County: OKLAHOMA
License: 30540
Dated: 5/12/2014
Expires: 5/1/2025
Temp. Lic. Issued: 3/21/2014
Temp. Lic. Expires: 5/16/2014
License Type: Medical Doctor
Specialty: Pediatric Surgery (Surgery)
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: NO
Medical School: Raymond & Ruth Perelman Sch of Med at Univ of PA, Philadelphia, PA
Graduated: 5 / 1993
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.
Certifications: AMERICAN BOARD OF SURGERY - Pediatric Surgery
AMERICAN BOARD OF SURGERY (Surgery specific)
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: INTEGRIS Baptist Medical Center
Oklahoma City, OK
Locations: Hours: Languages:
INTEGRIS BAPTIST MEDICAL CENTER
3300 NW EXPRESSWAY
MWT 1210
OKLAHOMA CITY OK 73112

Phone #: (405) 949-3011
Fax #:
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
SHANNON MICHELLE JACOBY PA 1998
JULIE MARIE REDINGTON PA 1399
PATRICIANN MICHAEL TATE PA 1744
ANGELA MARIE WROBLESKI PA 1400

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