Individual
CHARLES C POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7501 RIVERSIDE PKWY, TULSA, OK 74136
(918) 710-4200
(918) 403-6331
Mailing address
7501 RIVERSIDE PKWY, TULSA, OK 74136-5056
(918) 710-4200
(918) 403-6331
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
23749
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200021790A
—
OK
Enumeration date
01/30/2006
Last updated
07/11/2018
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