Individual
DR. CHARLES S NORTHUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 ROCKEFELLER DR, MUSKOGEE, OK 74401-5075
(918) 478-5517
(918) 478-5519
Mailing address
PO BOX 268947, OKLAHOMA CITY, OK 73126-8947
(918) 478-5517
(918) 478-5519
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
20429
OK
Other
Enumeration date
10/12/2007
Last updated
10/12/2007
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