Healthcare Provider Details

I. General information

NPI: 1215145255
Provider Name (Legal Business Name): CHARLES FRANCIS HARVEY DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 NE 10TH ST
OKLAHOMA CITY OK
73117-1299
US

IV. Provider business mailing address

3606 ROSEWOOD DR
MIDWEST CITY OK
73110
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-4060
  • Fax: 405-271-6680
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2953
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: