Individual
CHARLES JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.P.A.
Contact information
Practice address
4500 S GARNETT RD, TULSA, OK 74146-5229
(918) 664-9892
Mailing address
5739 E 65TH ST, TULSA, OK 74136-2721
(918) 513-2493
Taxonomy
Speciality
Code
Description
License number
State
243U00000X
Radiology Practitioner Assistant
Primary
13OK1467
OK
Other
Enumeration date
05/20/2013
Last updated
05/20/2013
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