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Contact Information

CHARLES D ANDERSON, DPM
817 24TH AVE NW
NORMAN, OK73069-6313
 Phone: 405-360-9338
 Fax: 405-366-1669
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery, Foot & Ankle

213ES0103X 48 Podiatry
Indicates primary specialty

NPI Profile & details for CHARLES D ANDERSON · (Male)

NPI # 1790779890
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 09/02/2005
Last updated 03/17/2018 - About 8 years ago
Sole proprietor 1 Yes
Identifiers
  • OK License # 190
  • OK Medicaid 100779900A
Hospital affiliation(s)
  • NORMAN REGIONAL HEALTH SYSTEM - (Acute Care)
    901 NORTH PORTER
    NORMAN, OK 73070
  • SURGICAL HOSPITAL OF OKLAHOMA - (Acute Care)
    100 SOUTHEAST 59TH STREET
    OKLAHOMA CITY, OK 73129
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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