Healthcare Provider Details
I. General information
NPI: 1932299286
Provider Name (Legal Business Name): CARTER PROFESSIONAL CARE, CORP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/14/2006
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1241 E 33RD ST
EDMOND OK
73013-6307
US
IV. Provider business mailing address
1241 E 33RD ST
EDMOND OK
73013-6307
US
V. Phone/Fax
- Phone: 405-562-4221
- Fax: 855-940-4087
- Phone: 405-562-4221
- Fax: 855-940-4087
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RICHARD
SCOTT
CARTER
Title or Position: CEO
Credential:
Phone: 405-514-7254