Individual
CHARLES STILWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
13 S 2ND ST, STILWELL, OK 74960-3105
(918) 696-6826
(918) 516-0479
Mailing address
13 S 2ND ST, STILWELL, OK 74960-3105
(918) 696-6826
(918) 516-0479
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200556050A
—
OK
Enumeration date
06/18/2015
Last updated
06/18/2015
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