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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Saturday, November 23, 2024 3:48 AM CST
Next Update: Saturday, November 23, 2024 12:00 PM CST

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MEDLEY, SHANNON JAMESON       
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: INTERVENTIONAL PAIN MANAGEMENT
13601 MEMORIAL PARK DR SUITE 200
OKLAHOMA CITY OK 73120-1856

Address last updated on 7/11/2024
Phone #: (405) 340-2100
Fax #:
County: OKLAHOMA
License: 1614
Dated: 4/1/2007
Expires: 3/31/2025
Temp. Ltr. Issued: 1/26/2007
Temp. Ltr. Expires: 5/19/2007
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:
INTERVENTIONAL PAIN MANAGEMENT
13601 MEMORIAL PARK DR SUITE 200
OKLAHOMA CITY OK 73120-1856

Phone #: (405) 340-2100
Fax #:

Hospital Privileges:

None listed

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
BLAKE CHRISTENSEN DO 4887
SARAH KATHARINE PETTY MD 30747
NOEL ROBERT WILLIAMS MD 17885

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