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NPI Code Detail

MEDICARE: TIM CARLTON PROSTHETICS INC.

MEDICARE: TIM CARLTON PROSTHETICS INC.
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
1335E00000XProsthetic/Orthotic Supplier

General Provider Information

NPI Number : 1679568125
Entity Type Code : Organization
Provider Name (Legal Business Name) : TIM CARLTON PROSTHETICS INC.
Provider Business Mailing Address
First Line : 9414 WESTGATE RD
Second Line : SUITE B.
City : OKLAHOMA CITY
State : OK
Zip : 73162-6245
Country : US
Telephone Number : 405-721-7570
Fax Number : 405-721-7599
Provider Business Practice Location Address
First Line : 9414 WESTGATE RD
Second Line : SUITE B.
City : OKLAHOMA CITY
State : OK
Zip : 73162-6245
Country : US
Telephone Number : 405-721-7570
Fax Number : 405-721-7599
Authorized Official
Title or Position : OWNER / PROSTHETIST
Name : MR. TIMOTHY RAY CARLTON
Credential : C.P. L.P.
Telephone Number : 405-721-7570
Provider Enumeration Date : 09/12/2005
Last Update Date : 08/22/2020

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