Mettry, Charles R

Mettry, Charles R is an individual health care provider with primary practice located at 201 N Monte Vista St Suite B, Ada OK 74820-7200. He recently has only one registered license in Allopathic & Osteopathic Physicians / Adolescent Medicine, which is considered as his primary health care specialty. Mettry, Charles R can be contacted via phone (580) 436-4200.

Contact Information

Primary practice address
201 N Monte Vista St Suite B Ada OK 74820-7200
Phone: (580) 436-4200
Fax: (580) 436-6423
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X 2206 Oklahoma

Profile Details

NPI number 1871581470
LBN Legal business name Mettry, Charles R
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 10th, 2005
Last updated Aug 17th, 2009 - about 16 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 1871581470 NPPES
Oklahoma Other 38-2376906 FED ID
Oklahoma MEDICAID 100111120A FED ID

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