MATTOX, JEREMIAH DAVID - Licensee Information

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Last Update: Thursday, November 21, 2024 1:14 PM CST
Next Update: Thursday, November 21, 2024 4:30 PM CST

MATTOX, JEREMIAH DAVID

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:	CLASSEN URGEN CARE CLINIC 2818 CLASSEN BLVD NORMAN OK 73071 Address last updated on 3/25/2024
Phone #:	(405) 740-2363
Fax #:
County:	CLEVELAND
License:	2841
Dated:	12/19/2017
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:
CLASSEN URGEN CARE CLINIC 2818 CLASSEN BLVD NORMAN OK 73071 Phone #: (405) 740-2363 Fax #:

Hospital Privileges:

Mercy Hospital Ada (frmly Valley View Regional Hospital)
Ada, OK

Name:	Type:	License Number:
Primary Supervisor(s):
HAROLD NATHANIAL CLAVER	DO	4746
KATHRYN HALL	DO	2952
BENJAMIN DAVID LYNCH	MD	29897
BRENDA JOYCE MAH-MCCAA	MD	34369
RODNEY MCCRORY	DO	2750
SHELLY ZIMMERMAN	DO	3056

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