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NPI Code Detail

MEDICARE: MR. CHARLES POLLARD III NP

MEDICARE: MR. CHARLES POLLARD III NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner87886OK

General Provider Information

NPI Number : 1497164396
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. CHARLES POLLARD III NP
Provider Business Mailing Address
First Line : 102 WOODMONT BLVD STE 600
Second Line :
City : NASHVILLE
State : TN
Zip : 37205-5250
Country : US
Telephone Number : 889-871-1518
Fax Number :
Provider Business Practice Location Address
First Line : 6951 SE 15TH ST
Second Line :
City : MIDWEST CITY
State : OK
Zip : 73110-2748
Country : US
Telephone Number : 405-233-0450
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2014
Last Update Date : 07/07/2023

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