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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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FAGAN, STACY LOUISE       
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: MERCY CONVENIENT CARE
OKLAHOMA CITY OK 73012

Address last updated on 2/6/2024
Phone #: (785) 979-8101
Fax #:
County: OKLAHOMA
License: 1779
Dated: 4/1/2009
Expires: 3/31/2025
Temp. Ltr. Issued: 11/7/2008
Temp. Ltr. Expires: 4/4/2009
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:
MERCY CONVENIENT CARE
OKLAHOMA CITY OK 73012

Phone #: (785) 979-8101
Fax #:

Hospital Privileges:

None listed

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
ERIN K ALLEN DO 4269
STEPHEN AKIRA HOPKINS MD 24615
JEANIE L KLABZUBA DO 4229
GARY MONROE LAWRENCE MD 14150
CASEY LYNN MARKLAND MD 24603
BRENDON MCCOLLOM DO 4315
SACHIDANANDAN NAIDU MD 21643
VISAL POK MD 24047
JOHN EDWARD SEGUIN MD 19008
JIGNESH JAYESHCHANDRA VERAGIWALA MD 23499

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