1003324518 NPI number — EMILY ANN CARTER

Table of content: EMILY ANN CARTER (NPI 1003324518)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003324518 NPI number — EMILY ANN CARTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CARTER
Provider First Name:
EMILY
Provider Middle Name:
ANN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003324518
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/18/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6600 S YALE AVE STE 1400
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TULSA
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
74136-3331
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
888-247-0125
Provider Business Mailing Address Fax Number:
918-502-8001

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7858 S OLYMPIA AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TULSA
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
74132-1857
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
918-986-9250
Provider Business Practice Location Address Fax Number:
918-986-9205
Provider Enumeration Date:
01/18/2018

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363A00000X , with the licence number:  2870 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)