Individual
CHARLES A JANTZEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
915 E GARRIOTT RD, SUITE A, ENID, OK 73701-6156
(580) 977-1910
(580) 237-1925
Mailing address
5300 N INDEPENDENCE AVE, 280, OKLAHOMA CITY, OK 73112-5556
(580) 977-1910
(580) 237-1925
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5574
OK
Other
Enumeration date
04/22/2013
Last updated
10/06/2017
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