Organization
MOORE PRIMARY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL CARTER PA-C (PA-C)
(405) 799-7400
Entity
Organization
Contact information
Practice address
1400 SE 4TH ST, SUITE H, MOORE, OK 73160-7329
(405) 799-7400
(405) 799-7405
Mailing address
1400 SE 4TH ST, SUITE H, MOORE, OK 73160-7329
(405) 799-7400
(405) 799-7405
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200079670A
—
OK
Enumeration date
04/25/2011
Last updated
04/25/2011
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