Fullenwider, Charles Berry

Fullenwider, Charles Berry is an individual health care provider with primary practice located at 4318 W Okmulgee St , Muskogee OK 74401-4648. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurological Surgery, which is considered as his primary health care specialty. Fullenwider, Charles Berry can be contacted via phone (918) 683-1238.

Contact Information

Primary practice address
4318 W Okmulgee St Muskogee OK 74401-4648
Phone: (918) 683-1238
Fax: (918) 683-1239
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X 12300 Oklahoma

Profile Details

NPI number 1447245063
LBN Legal business name Fullenwider, Charles Berry
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2005
Last updated May 1st, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447245063 NPPES
Oklahoma MEDICAID 100100060A

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