Individual
MR. CHARLES HARRISON HAWTHORNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
920 STANTON L YOUNG BLVD # WP1140, OKLAHOMA CITY, OK 73104-5036
(405) 271-4351
(405) 271-8695
Mailing address
PO BOX 26901, OKLAHOMA CITY, OK 73126-0901
(405) 271-4351
(405) 271-8695
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
068184
LA
367500000X
Certified Registered Nurse Anesthetist
Primary
205234
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1569739
—
LA
Enumeration date
11/09/2006
Last updated
12/04/2021
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