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General NPI Number Information
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NPI Number | 1750662169
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Entity Type | Organization
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Legal Business Name | CARMA MEDICAL, PLLC
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Dates
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Enumeration Date | 08/31/2011
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Last Update Date | 07/03/2013
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Provider Practice Location Address
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Address Line | 1218 E 9TH ST SUITE 5
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City | EDMOND
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State | OK
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Zip | 73034-5952
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Country | US
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Telephone | 405-513-7771
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Fax | 405-513-7725
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Provider Business Mailing Address
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Address Line | 1218 E 9TH ST STE 5
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City | EDMOND
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State | OK
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Zip | 73034-5952
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Country | US
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Telephone | 405-513-7771
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Fax | 405-513-7725
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Authorized Official
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Title or Position | OWNER
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Name | MACK WALKER
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Credential | NREMT-P
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Telephone | 405-513-7771
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | R0058479
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License Number State | OK
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