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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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VALENCIA, JALYSSA ERICKA       
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: CALDWELL MEDICAL GROUP
2109 US-HWY 69
WAGONER OK 74467

Address last updated on 2/12/2024
Phone #: (918) 485-6069
Fax #: (888) 815-0475
County: WAGONER
License: 4938
Dated: 2/6/2023
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:
CALDWELL MEDICAL GROUP
2109 US-HWY 69
WAGONER OK 74467

Phone #: (918) 485-6069
Fax #: (888) 815-0475

Hospital Privileges:

Wagoner Community Hospital
Wagoner, OK

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
KAMMIE MARIA CALDWELL MD 24211

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