Provider Demographics
NPI:1730260084
Name:ALEXIS, CHARLES J (MD)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:J
Last Name:ALEXIS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7348 EDENBOROUGH DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73132-5616
Mailing Address - Country:US
Mailing Address - Phone:405-270-0501
Mailing Address - Fax:405-290-1887
Practice Address - Street 1:921 NE 13TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5007
Practice Address - Country:US
Practice Address - Phone:405-270-0501
Practice Address - Fax:405-290-1887
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PR157732084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK77948OtherEMPOYE IDENTIFICATION NUM