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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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MAHANA, CRYSTAL AMY       
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: INTEGRIS BAPTIST MEDICAL CENTER
3300 NW EXPRESSWAY
OKLAHOMA CITY OK 73112

Address last updated on 3/19/2024
Phone #: (405) 949-3011
Fax #:
County: OKLAHOMA
License: 2955
Dated: 10/29/2018
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:
INTEGRIS BAPTIST MEDICAL CENTER
3300 NW EXPRESSWAY
OKLAHOMA CITY OK 73112

Phone #: (405) 949-3011
Fax #:

Hospital Privileges:

None listed

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
BOB R ABERNATHY DO 2075
JUBEL JHUN SULLANO BILBAO MD 25741
KEITH ALAN CONAWAY MD 19091
MAYANK NANDKISHOR DAVE MD 25648
KENNETH MARK DUFFY MD 12688
JACINDA LEADFORD DO 5901
JOSH ERIC MCWILLIAMS MD 23717
DILLON JACK ROACH MD 26891
JOE WITTEN DO 4257

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