Individual
CHARLES RAY JENNINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
206 E BLUE STARR DR, CLAREMORE, OK 74017-4223
(918) 341-8100
(918) 341-8139
Mailing address
235 W 6TH ST, CHELSEA, OK 74016-1833
(918) 341-8100
(918) 341-8139
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1549
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200113160A
—
OK
Enumeration date
12/22/2006
Last updated
02/07/2023
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