MEDICARE: DR. G. E. CARPENTER D.C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	1678	OK

General Provider Information

NPI Number	:	1063478444
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. G. E. CARPENTER D.C

Provider Business Mailing Address
First Line	:	9820 NE 23RD ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73141-4208
Country	:	US
Telephone Number	:	405-769-6767
Fax Number	:	405-769-6775

Provider Business Practice Location Address
First Line	:	9820 NE 23RD ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73141-4208
Country	:	US
Telephone Number	:	405-769-6767
Fax Number	:	405-769-6775

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/25/2006
Last Update Date	:	06/11/2008

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Directions to “ DR. G. E. CARPENTER D.C” Practice Location

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