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Next Update: Thursday, December 19, 2024 12:00 PM CST
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FULLENWIDER, CHARLES BERRY
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This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.
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| Practice Address: |
4318 W OKMULGEE
MUSKOGEE OK 74401
Address last updated on 6/13/2023 |
| Phone #: |
(918) 683-1238 |
| Fax #: |
(918) 682-8087 |
| County: |
MUSKOGEE |
| License: |
12300 |
| Dated: |
7/2/1979 |
| Expires: |
7/1/2025 |
| License Type: |
Medical Doctor |
| Specialty: |
Neurological Surgery |
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| Status: |
Active |
| Status Class: |
Fully Licensed |
| Restricted to: |
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| Registered to Dispense: |
NO |
| Medical School: |
Univ Of Ok Coll Of Med, Oklahoma City Ok 73190 |
| Graduated: |
6 /
1978 |
| CME Year: |
2027 |
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Pending and/or Past Disciplinary Actions:
No Disciplinary Action Taken.
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All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
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| Certifications: |
AMERICAN BOARD OF NEUROLOGICAL SURGERY |
| New Patients: |
Yes |
| Medicaid: |
Yes |
| Medicare: |
Yes |
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| HMO/PPO: |
BlueChoice PPO
HealthChoice
Preferred Community Choice |
| Hospital Privileges: |
Eastar Health System (fmly Muskogee Regional Med Ctr)
Muskogee, OK
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