Individual
THOMAS M CARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 FAIRVIEW AVE, SUITE 21, PONCA CITY, OK 74601
(580) 765-3356
(580) 765-3353
Mailing address
400 FAIRVIEW, SUITE 21, PONCA CITY, OK 74601
(580) 765-3356
(580) 765-3353
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
8690
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100116530A
—
OK
01
—
731007150001
BLUE CROSS/BLUE SHIELD
OK
Enumeration date
06/12/2006
Last updated
05/29/2009
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