Individual
CHARLES BLAGOVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6600 S YALE AVE, TULSA, OK 74136-3347
(740) 505-7569
Mailing address
6600 S YALE AVE, TULSA, OK 74136-3347
(740) 505-7569
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
121198
OK
Other
Enumeration date
07/11/2016
Last updated
07/11/2016
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