# CARY CARPENTER, M.D. P.C.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Choctaw Family Medicine & Aesthetics
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124108378
- **Authorized official:** MRS. LORRIE A CARPENTER (ADMINISTRATOR)
- **Authorized official phone:** (405) 808-7765

## Contact information

- **Practice address:** 15809 NE 23RD ST, CHOCTAW, OK 73020-8428
- **Practice address phone:** (405) 390-9600
- **Practice address fax:** (405) 390-9400
- **Mailing address:** PO BOX 10, CHOCTAW, OK 73020-0010
- **Mailing address phone:** (405) 390-9600
- **Mailing address fax:** (405) 390-9400

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 18237 | OK | Yes |

## Other

- **Enumeration date:** 10/16/2006
- **Last updated:** 02/21/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100113820B | — | OK |
| 05 | — | 100113820D | — | OK |
| 05 | — | 100113820E | — | OK |
| 01 | — | 1053311548 | NPI - CARY CARPENTER M.D. | — |
| 01 | — | 1164597860 | NPI - PHYSICIAN ASSISTANT BILLY SANDERS | — |
| 01 | — | 1861479255 | NPI-BRUCE STAFFORD, DO - | OK |
| 01 | — | 1861479255 | NPI - BRUCE STAFFORD, D.O. | — |
| 05 | — | 200100040A | — | OK |
| 01 | — | 241409404 | MEDICARE INDIVIDUAL P-TAN FOR BRUCE STAFFORD, D.O. | — |
| 01 | — | 249341123 | MEDICARE INDIVIDUAL P-TAN - CARY CARPENTER M.D. | — |
| 01 | — | 444745244-001 | CARY CARPENTER -BCBS | OK |
| 01 | — | 446-46-7483-001 | BCBS-BRUCE STAFFORD, DO | OK |
| 01 | — | 44646 | BLUE LINCS - BRUCE STAFFORD, DO | OK |
| 01 | — | 900522085 | MEDICARE GROUP P-TAN --CARY CARPENTER MD PC DBA CHOCTAW FAMILY MEDICINE | — |
| 01 | — | F43282 | MEDICARE UPIN - CARY CARPENTER M.D. | — |
| 01 | — | I00757 | MEDICARE UPIN - BRUCE STAFFORD, D.O. | — |