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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Wednesday, December 18, 2024 6:43 PM CST
Next Update: Thursday, December 19, 2024 2:50 AM CST

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STANGL, SHANNON MARIE       
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: 7919 MID AMERICA BLVD
OKLAHOMA CITY OK 73135

Address last updated on 11/18/2024
Phone #: (405) 855-6000
Fax #:
County: OKLAHOMA
License: 2977
Dated: 10/24/2018
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:
7919 MID AMERICA BLVD
OKLAHOMA CITY OK 73135

Phone #: (405) 855-6000
Fax #:

Hospital Privileges:

None listed

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
RODRIGO ALBA MARIANO MD 20512
GODWIN SALIFU MATTHEW MD 34474

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