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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Wednesday, December 18, 2024 6:43 PM CST
Next Update: Thursday, December 19, 2024 2:50 AM CST

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NOTTINGHAM, BRAXTON LANE       
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: 2557 OLD TIMBERS DR
EDMOND OK 73034

Address last updated on 5/30/2024
Phone #: (405) 669-2600
Fax #: (405) 500-1636
County: OKLAHOMA
License: 32946
Dated: 7/1/2018
Expires: 7/1/2025
License Type: Medical Doctor
Specialty: Family Medicine
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of Ok Coll Of Med, Oklahoma City Ok 73190
Graduated: 5 / 2017
CME Year: 2027
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 FAMILY MEDICINE
New Patients: Yes
Medicaid: Yes
Medicare: Yes
   
HMO/PPO: None listed
Hospital Privileges: INTEGRIS Baptist Medical Center
Oklahoma City, OK
Locations: Hours: Languages:
2557 OLD TIMBERS DR
EDMOND OK 73034

Phone #: (405) 669-2600
Fax #: (405) 500-1636
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
AMY CASEY APRN 87170
JERI HARGRAVE APRN 37216
ALEXANDRIA MARTIN APRN 113320
TAYLOR JORDAN MENDELL PA 4635
JOEL GEORGE SAJAN PA 4936
TEEIA STROUT APRN 112399
CORY YOUNG APRN 126295

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