Provider Demographics
NPI:1144382482
Name:DYE, CHARLES H (DC)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:H
Last Name:DYE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1827
Mailing Address - Street 2:
Mailing Address - City:CLAREMORE
Mailing Address - State:OK
Mailing Address - Zip Code:74018-1827
Mailing Address - Country:US
Mailing Address - Phone:918-636-2244
Mailing Address - Fax:918-342-3751
Practice Address - Street 1:202 W. BLUE STARR DRIVE
Practice Address - Street 2:
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74017-4228
Practice Address - Country:US
Practice Address - Phone:918-342-3737
Practice Address - Fax:918-342-3751
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2205111N00000X
OKOK2205111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKQDCJSMedicare ID - Type Unspecified