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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Sunday, December 22, 2024 1:13 PM CST
Next Update: Sunday, December 22, 2024 4:30 PM CST

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INTERWICZ, SCOTT RANDALL       
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 HOSPITAL LOGAN COUTNY
200 S. ACADEMY RD
GUTHRIE OK 73044

Address last updated on 2/18/2024
Phone #: (405) 282-5125
Fax #:
County: OKLAHOMA
License: 2304
Dated: 12/13/2013
Expires: 3/31/2025
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 HOSPITAL LOGAN COUTNY
200 S. ACADEMY RD
GUTHRIE OK 73044

Phone #: (405) 282-5125
Fax #:

Hospital Privileges:

Mercy Hospital Logan County (fmly Logan Hosp. and MC)
Guthrie, OK
Mercy Hospital OKC
Oklahoma City, OK

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
CHAD BORIN DO 3746
CHRISTOPHER BRADSHAW DO 5189
BRANDON STEPHEN BROWN MD 27722
Travis Buckner DO 6373
CONRAD C CALDWELL III MD 22805
ROBERT DANFORD CRANE MD 27260
ANDREW EATON DO 5372
JESSE RAY HILL MD 26139
DATHAN DUANE JAY MD 23512
JOSH ERIC MCWILLIAMS MD 23717
BRENT ALAN MEFFORD MD 25486
JUAN CARLOS NALAGAN MD 20356
MICHAEL DUANE PLINSKY MD 26506
BRIAN JOSEPH SEATON MD 20579
STEPHEN KOJI SPARKS DO 4559
ALEXIA SMITH WRIGHT MD 27510

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