Individual
CHARLES R METTRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
201 N MONTE VISTA ST STE B, ADA, OK 74820-7220
(580) 436-4200
(580) 436-6423
Mailing address
201 N MONTE VISTA ST STE B, ADA, OK 74820-7220
(580) 436-2000
(580) 436-6423
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
2206
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100111120A
—
OK
01
—
38-2376906
FED ID
OK
Enumeration date
10/10/2005
Last updated
11/13/2025
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