Organization
CHARGER HEALTH GROUP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS S BLACKSTAD DO (OWNER)
(918) 605-6582
Entity
Organization
Contact information
Practice address
511 N ASPEN AVE, BROKEN ARROW, OK 74012-2220
(918) 806-8050
(918) 806-8090
Mailing address
PO BOX 342, BROKEN ARROW, OK 74013-0342
(918) 605-6582
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
09/14/2020
Last updated
09/22/2020
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