Provider Demographics
NPI:1417918152
Name:HARMON, CHARLES KEMPER (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:KEMPER
Last Name:HARMON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:6600 S YALE AVE
Mailing Address - Street 2:SUITE 1200
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3310
Mailing Address - Country:US
Mailing Address - Phone:918-488-6000
Mailing Address - Fax:918-488-6098
Practice Address - Street 1:6600 S. YALE AVE
Practice Address - Street 2:SUITE 1200
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136
Practice Address - Country:US
Practice Address - Phone:918-488-6000
Practice Address - Fax:918-488-6098
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK11047208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100050760AMedicaid
OK100050760AMedicaid