CHARLES LEON DICK JR. (NPI# 1003249392) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1003249392 |
Entity Type | Individual |
Full Name | CHARLES LEON DICK JR. |
Credential | BS |
Practice Address |
711 N East Ave Apt E6 Tahlequah OK 74464-2407 |
Practice Telephone | 9185064007 |
Mailing Telephone | 9185064007 |
Enumeration Date | 2013-08-09 |
Last Update Date | 2016-04-05 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982249488 | Charles Wayne Dick Jr. | Massage Therapist | 1400 Battleground Ave Ste 120d, Greensboro, NC 27408-8038 | 2019-11-08 |
1750793048 | Charles Tyler Dick | Registered Nurse | 929 N Saint Francis St, Wichita, KS 67214-3821 | 2014-05-21 |
1639263882 | Charles Dick | Psychiatry & Neurology | 100 Rockford Drive, Newark, DE 19713 | 2006-10-03 |
Street Address |
711 N EAST AVE APT E6 |
City | TAHLEQUAH |
State | OK |
Zip Code | 74464-2407 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1184253403 | Kendall Harris | Student in an Organized Health Care Education/Training Program | 100 Bliss Ave, Tahlequah, OK 74464 | 2020-04-07 |
1528609302 | Norma Brightly | Technician | 103 Sequoyah, Tahlequah, OK 74464 | 2019-10-03 |
1073175832 | Jody Lynn Dallis | Case Manager/Care Coordinator | Tenkiller Behavioral Services, 27753 S. Welling Rd, Welling, OK 74464 | 2019-07-02 |
1184287849 | Perry Jake Proctor | Student in an Organized Health Care Education/Training Program | 1400 E Downing St, Tahlequah, Ok 74464, Tahlequah, OK 74464 | 2019-04-18 |
1336657279 | Sidney Sheyenne Kimble | Case Manager/Care Coordinator | 1429 Jack Brown Lane, Tahlequah, OK 74464 | 2018-01-12 |
1891225686 | Nichols Bradley Alberty | Orthotist | 1294 East Downing, Suite 3, Tahlequah, OK 74464 | 2017-06-14 |
1922549690 | Krystal Easter Ms, Lpc | Counselor | 2201 Oakridge Dr, Tahlequah, OK 74464 | 2017-03-15 |
1144777319 | Northeastern Oklahoma Community Health Centers, Inc. | Clinic/Center | 529 N. Oak St., Tahlequah, OK 74464 | 2016-09-06 |
1548713456 | Clement Isioma Nwadozi | Optometrist | 3763 Southridge Cir Apt 6, Tahlequah, OK 74464 | 2016-07-27 |
1033532635 | Wesley Gragg | Specialist/Technologist | 603 North Grand Avenue, Tahlequah, OK 74464 | 2014-02-03 |
Find all providers in zip 74464 |
Taxonomy Code | 390200000X |
Grouping | Student, Health Care |
Classification | Student in an Organized Health Care Education/Training Program |
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
Notes: [1/1/2005: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1184253403 | Kendall Harris | Student in an Organized Health Care Education/Training Program | 100 Bliss Ave, Tahlequah, OK 74464 | 2020-04-07 |
1184287849 | Perry Jake Proctor | Student in an Organized Health Care Education/Training Program | 1400 E Downing St, Tahlequah, Ok 74464, Tahlequah, OK 74464 | 2019-04-18 |
1790309938 | Bryan John Butel | Student in an Organized Health Care Education/Training Program | 1400 E Downing St, Tahlequah, OK 74464-3324 | 2020-06-03 |
1932723277 | Xuanchinh Tran | Student in an Organized Health Care Education/Training Program | 1373 E Boone St Ste 2300, Tahlequah, OK 74464-3365 | 2020-06-02 |
1952930257 | Athena Chatzigiannidis | Student in an Organized Health Care Education/Training Program | 100 S Bliss Ave, Tahlequah, OK 74464-2512 | 2020-04-07 |
1942839394 | Sean Crawford | Student in an Organized Health Care Education/Training Program | 100 S Bliss Ave, Tahlequah, OK 74464-2512 | 2020-04-07 |
1205463767 | Rahim Ruknudin Sewani | Student in an Organized Health Care Education/Training Program | 1400 E Downing St, Tahlequah, OK 74464-3324 | 2020-03-25 |
1104468610 | Lista Marie Watkins | Student in an Organized Health Care Education/Training Program | 1500 E Downing St Ste 214, Tahlequah, OK 74464-3379 | 2019-10-16 |
1811553761 | Kate Allen | Student in an Organized Health Care Education/Training Program | 1373 E Boone St Ste 2300, Tahlequah, OK 74464-3365 | 2019-05-16 |
1154985869 | David Ryan Markes | Student in an Organized Health Care Education/Training Program | 100 S Bliss Ave, Tahlequah, OK 74464-2512 | 2019-04-28 |
Find all providers in TAHLEQUAH |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.