NPI 1740403088

Charles Joseph Wine, MD

Practitioner Otolaryngology Physician Tahlequah, OK

Practice location

Address: 100 S Bliss Ave, Tahlequah, OK 74464-2512
Phone: (918) 458-3360
Fax: (918) 458-3511
Mailing address: 3117 Hickory Stick Rd, Oklahoma City, OK 73120-6001

Registered specialties

Otolaryngology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Y00000X Licence 9465 (OK)

Other Otolaryngology providers in Oklahoma →

Registry record

NPI: 1740403088
Entity type: Individual
Sex (as registered): Male
NPI issued: 11 Apr 2007
Record last updated: 9 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.