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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Tuesday, December 24, 2024 6:44 PM CST
Next Update: Wednesday, December 25, 2024 2:50 AM CST

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MELLOTT, JOHN ERIC       
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 EDMOND
4801 INTEGRIS PKWY
EDMOND OK 73034

Address last updated on 3/4/2024
Phone #: (405) 657-3000
Fax #:
County: OKLAHOMA
License: 566
Dated: 8/2/2017
Expires: 3/31/2025
Temp. Ltr. Issued: 9/22/2022
Temp. Ltr. Expires: 11/17/2022
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 EDMOND
4801 INTEGRIS PKWY
EDMOND OK 73034

Phone #: (405) 657-3000
Fax #:

Hospital Privileges:

None listed

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
RODNEY MCCRORY DO 2750
JARROD JAMES MUEGGENBORG DO 4935

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