MEDICARE: WILLIAM J CARTER M.D.

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	207Q00000X	Family Medicine Physician	11195	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4102240001	OTHER		PALMETTO
2	A003	OTHER		TRI CARE STD

General Provider Information

NPI Number	:	1831193341
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM J CARTER M.D.

Provider Business Mailing Address
First Line	:	925 SE PADDOCK CT
Second Line	:
City	:	BARTLESVILLE
State	:	OK
Zip	:	74006-7717
Country	:	US
Telephone Number	:	919-333-1093
Fax Number	:

Provider Business Practice Location Address
First Line	:	925 SE PADDOCK CT
Second Line	:
City	:	BARTLESVILLE
State	:	OK
Zip	:	74006-7717
Country	:	US
Telephone Number	:	919-333-1093
Fax Number	:

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

Provider Enumeration Date	:	06/13/2005
Last Update Date	:	07/09/2007

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Directions to “ WILLIAM J CARTER M.D.” Practice Location

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