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NPI Code Detail

MEDICARE: DR. CHARLES EATON STEWART M.D. PH.D.

MEDICARE: DR. CHARLES EATON STEWART M.D. PH.D.
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
12085R0001XRadiation Oncology Physician24962OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1043243884
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHARLES EATON STEWART M.D. PH.D.
Provider Business Mailing Address
First Line : 11212 E 48TH ST
Second Line :
City : TULSA
State : OK
Zip : 74146-5824
Country : US
Telephone Number : 918-497-3715
Fax Number : 918-884-7282
Provider Business Practice Location Address
First Line : 11212 E 48TH ST
Second Line :
City : TULSA
State : OK
Zip : 74146-5824
Country : US
Telephone Number : 918-497-3715
Fax Number : 918-884-7282
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2006
Last Update Date : 10/28/2020

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