Healthcare Provider Details

I. General information

NPI: 1194702696
Provider Name (Legal Business Name): CHARLES WHITING MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2005
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 NE NEFF RD
BEND OR
97701-6015
US

IV. Provider business mailing address

1921 STONECIPHER BLVD
ADA OK
74820
US

V. Phone/Fax

Practice location:
  • Phone: 541-706-4984
  • Fax: 541-706-5925
Mailing address:
  • Phone: 580-421-4570
  • Fax: 580-421-6283

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number22223
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: