Healthcare Provider Details

I. General information

NPI: 1538165550
Provider Name (Legal Business Name): TOM STEPHEN CARTER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2005
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 E BROADWAY ST STE 102
ALTUS OK
73521-5506
US

IV. Provider business mailing address

1001 HWY 83 N
CHILDRESS TX
79201-1030
US

V. Phone/Fax

Practice location:
  • Phone: 580-480-1600
  • Fax: 580-480-1601
Mailing address:
  • Phone: 940-937-3636
  • Fax: 940-937-9644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number18517
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberJ6895
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberJ6895
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number18517
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: