Provider Demographics
NPI:1831365428
Name:CHARLES T. EILER, INC.
Entity type:Organization
Organization Name:CHARLES T. EILER, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:T
Authorized Official - Last Name:EILER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:918-250-9288
Mailing Address - Street 1:8026 S MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-3644
Mailing Address - Country:US
Mailing Address - Phone:918-250-9288
Mailing Address - Fax:918-250-8171
Practice Address - Street 1:8026 S MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-3644
Practice Address - Country:US
Practice Address - Phone:918-250-9288
Practice Address - Fax:918-250-8171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-02
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5000261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental