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Last Update: Monday, November 4, 2024 1:08 PM CST
Next Update: Tuesday, November 5, 2024 4:30 PM CST

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JACOBY, SHANNON MICHELLE       
Practice Address: HOSPITAL & CLINIC WC PEDIATRIC SURGERY
6151 S YALE AVE
TULSA OK 74136

Address last updated on 5/9/2024
Phone #: (918) 494-9450
Fax #:
County: TULSA
License: 1998
Dated: 1/26/2011
Expires: 3/31/2025
Temp. Ltr. Issued: 1/21/2011
Temp. Ltr. Expires: 5/18/2011
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:
HOSPITAL & CLINIC WC PEDIATRIC SURGERY
6151 S YALE AVE
TULSA OK 74136

Phone #: (918) 494-9450
Fax #:

Hospital Privileges:

St. Francis Hospital
Tulsa, OK

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
BARRY ROBERT BERCH MD 32773
DARRELL LORNE CASS MD 30557
EDWARD GREGG FORD MD 28432
JEREMY JON JOHNSON MD 26424
DAVID LANNING MD 34456
LOUIS DUY CANH LE MD 33200
FLORENCE CATHERINE LEWIS MD 29923
ALPIN DEVENDRA MALKAN MD 37335
MARK VICTOR MAZZIOTTI MD 30540
MARCENE MCVAY-GILLAM MD 42264
ALEJANDRO ROBERTO RUIZ-ELIZALDE MD 28356

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