| |
202 W. Blue Starr Drive, Claremore, OK 74017-4228 | |
(918) 342-3737 | |
(918) 342-3751 |
Full Name | |
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Type | Facility |
Speciality | Clinic/center |
Location | 202 W. Blue Starr Drive, Claremore, Oklahoma |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1366987216 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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111N00000X | Chiropractor | (* (Not Available)) | Secondary |
261Q00000X | Clinic/center | 2205 (Oklahoma) | Primary |
Provider Name | Charles H Dye |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1144382482 PECOS PAC ID: 7911161047 Enrollment ID: I20120620000825 |
Mailing Address | Practice Location Address |
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Po Box 1827, Claremore, OK 74018-1827 Ph: (918) 636-2244 | 202 W. Blue Starr Drive, Claremore, OK 74017-4228 Ph: (918) 342-3737 |