Healthcare Provider Details

I. General information

NPI: 1578551412
Provider Name (Legal Business Name): WESTLEY A CARTER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2005
Last Update Date: 10/20/2025
Certification Date: 10/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 NW SHERIDAN RD
LAWTON OK
73505-5203
US

IV. Provider business mailing address

702 NW SHERIDAN RD
LAWTON OK
73505-5203
US

V. Phone/Fax

Practice location:
  • Phone: 580-678-2072
  • Fax:
Mailing address:
  • Phone: 580-576-3376
  • Fax: 580-576-3375

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number1051
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number8870
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: