Individual
DR. CHARLES WADE TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12697 E 51ST ST, TULSA, OK 74146-6236
(918) 505-3200
(918) 505-3253
Mailing address
12697 E 51ST ST, TULSA, OK 74146-6236
(918) 505-3200
(918) 505-3253
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
14470
OK
207RH0003X
Hematology & Oncology Physician
15268
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
331740YV6N
MEDICARE PTAN
OK
Enumeration date
06/13/2006
Last updated
05/01/2015
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