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1447245063
CHARLES BERRY FULLENWIDER
MUSKOGEE, OK
NPI
1447245063
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207T00000X Neurological Surgery
(Licence: OK 12300)
Enumeration Date
2005-09-20
Last Update Date
2023-05-01
Business Address
Dr. CHARLES BERRY FULLENWIDER M.D.
4318 W OKMULGEE ST
MUSKOGEE, OK 74401-4648
Phone number: 918-683-1238
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Mailing Address
Dr. CHARLES BERRY FULLENWIDER M.D.
6600 S YALE AVE STE 1400
TULSA, OK 74136-3331
Phone number:
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