Individual
DR. JASON ANDREW CARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MHSA, FACEP
Contact information
Practice address
1405 4TH AVE NW STE 96, ARDMORE, OK 73401-2708
(417) 612-3985
Mailing address
1405 4TH AVE NW, STE 96, ARDMORE, OK 73401-2708
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2011001438
MO
207P00000X
Emergency Medicine Physician
Primary
32576
OK
207P00000X
Emergency Medicine Physician
4301090607
MI
207P00000X
Emergency Medicine Physician
Q0887
TX
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
2011001438
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1376712935
—
MO
01
—
440552485
TRICARE
MO
01
—
O00955428
RR MCR
MO
Enumeration date
02/27/2008
Last updated
11/03/2016
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