Individual
MR. CHARLES SHACKELFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BS PHARM, D.PH.
Contact information
Practice address
316 E MAIN ST, PAWHUSKA, OK 74056-5218
(918) 287-9373
Mailing address
316 E MAIN ST, PAWHUSKA, OK 74056-5218
(918) 287-9373
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12586
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12586
STATE LICENCE NUMBER
OK
Enumeration date
10/10/2006
Last updated
02/15/2026
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