Individual
MR. CHARLES HENRY MYERS II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1313 E 20TH ST, OKMULGEE, OK 74447-6303
(918) 591-5700
(918) 758-1944
Mailing address
13003 S 5TH PL, JENKS, OK 74037-4448
(918) 652-5407
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
95442
OK
363LF0000X
Family Nurse Practitioner
Primary
95422
OK
Other
Enumeration date
07/17/2019
Last updated
11/26/2019
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