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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Sunday, December 22, 2024 6:44 PM CST
Next Update: Monday, December 23, 2024 2:50 AM CST

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WINZELER, TAYLOR 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: CRESCENT INFECTIOUS DISEASE
ACUTE CARE / LONG TERM
1111 N LEE AVE STE 249
OKLAHOMA CITY OK 73103

Address last updated on 3/28/2024
Phone #: (405) 594-5848
Fax #: (405) 594-5847
County: OKLAHOMA
License: 2215
Dated: 3/4/2013
Expires: 3/31/2025
Temp. Ltr. Issued: 2/15/2013
Temp. Ltr. Expires: 4/1/2013
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:
CRESCENT INFECTIOUS DISEASE
ACUTE CARE / LONG TERM
1111 N LEE AVE STE 249
OKLAHOMA CITY OK 73103

Phone #: (405) 594-5848
Fax #: (405) 594-5847

Hospital Privileges:

SSM Health St. Anthony Hospital - OKC
Oklahoma City, OK

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
SAUD IQBAL AHMED MD 29704
AHMAD ASHFAQ MD 30335
RYAN WAYNE DENNIS MD 27136
VALERIE NICOLE JOLLY MD 24633
VIJAY KUMAR KOLLI MD 28955
JULIE ST JOHN MAHANEY MD 31666
ERIN HOLLOMAN SCOTT MD 23909
STEPHEN KOJI SPARKS DO 4559

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