Healthcare Provider Details
I. General information
NPI: 1013987429
Provider Name (Legal Business Name): CHARLES ANTHONY HOWARD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/26/2006
Last Update Date: 03/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1919 S WHEELING AVE SUITE 600
TULSA OK
74104-5638
US
IV. Provider business mailing address
PO BOX 268838
OKLAHOMA CITY OK
73126-8838
US
V. Phone/Fax
- Phone: 918-744-3523
- Fax: 918-744-3463
- Phone: 918-660-3632
- Fax: 918-660-3631
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | 14841 |
| License Number State | OK |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086S0102X |
| Taxonomy | Surgical Critical Care Physician |
| License Number | 14841 |
| License Number State | OK |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: