Individual
CHARLES S OLEARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
1400 W PAWNEE ST, CLEVELAND, OK 74020-3020
(918) 358-3588
(918) 358-2637
Mailing address
1400 W PAWNEE ST, CLEVELAND, OK 74020-3020
(918) 358-3588
(918) 358-2639
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA 359
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100094130C
—
OK
Enumeration date
07/26/2007
Last updated
12/07/2020
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