VLADOVICH, STACEY ERIKA - Licensee Information

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Last Update: Friday, November 22, 2024 3:47 AM CST
Next Update: Friday, November 22, 2024 12:00 PM CST

VLADOVICH, STACEY ERIKA

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:	CROSSINGS CLINIC 222 NW 12TH ST OKLAHOMA CITY OK 73103 Address last updated on 3/15/2024
Phone #:	(405) 232-8631
Fax #:	(405) 601-3734
County:	OKLAHOMA
License:	3208
Dated:	8/20/2020
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:
CROSSINGS CLINIC 222 NW 12TH ST OKLAHOMA CITY OK 73103 Phone #: (405) 232-8631 Fax #: (405) 601-3734

Hospital Privileges:

None listed

Name:	Type:	License Number:	Full/Part Time:
Primary Supervisor(s):
JOSH ERIC MCWILLIAMS	MD	23717

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