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General NPI Number Information
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NPI Number | 1881934883
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Entity Type | Individual
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Provider Name | PAUL D CARPENTER D. PH.
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Gender | Male
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Dates
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Enumeration Date | 02/27/2013
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Last Update Date | 02/27/2013
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Provider Practice Location Address
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Address Line | 319 E JOSEPHINE AVE
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City | FREDERICK
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State | OK
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Zip | 73542-2220
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Country | US
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Telephone | 580-512-7467
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Fax |
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Provider Business Mailing Address
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Address Line | 3036 ASH CT
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City | WHITNEY
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State | TX
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Zip | 76692-5400
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Country | US
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Telephone | 580-512-7467
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 8441
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License Number State | OK
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