Organization
CHARLES W GARRETT III, MD, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES WALTER GARRETT III M.D. (PRESIDENT)
(918) 488-6608
Entity
Organization
Contact information
Practice address
6606 S YALE AVE, SUITE 205, TULSA, OK 74136-3364
(918) 488-6608
(918) 488-6609
Mailing address
6606 S YALE AVE, SUITE 205, TULSA, OK 74136-3364
(918) 488-6608
(918) 488-6609
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
17128
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004116209
AETNA
OK
05
—
200311360A
—
OK
01
—
442624408002
BLUE CROSS BLUE SHIELD
OK
01
—
DQ7156
RAILROAD MEDICARE
OK
Enumeration date
03/08/2007
Last updated
12/13/2010
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