MENDELL, TAYLOR JORDAN - Licensee Information

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Last Update: Thursday, December 19, 2024 3:44 AM CST
Next Update: Thursday, December 19, 2024 12:00 PM CST

MENDELL, TAYLOR JORDAN

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 HEALTH MEDICAL GROUP CROSS TIMBERS 2557 OLD TIMBERS DR EDMOND OK 73034 Address last updated on 3/25/2024
Phone #:	(405) 669-2600
Fax #:
County:	OKLAHOMA
License:	4635
Dated:	7/14/2021
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 HEALTH MEDICAL GROUP CROSS TIMBERS 2557 OLD TIMBERS DR EDMOND OK 73034 Phone #: (405) 669-2600 Fax #:

Hospital Privileges:

None listed

Name:	Type:	License Number:	Full/Part Time:
Primary Supervisor(s):
BRAXTON LANE NOTTINGHAM	MD	32946

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