Jason Daniel Carter, PHARMD
Individual provider Active NPI Pharmacy · Poteau, OK
NPI 1710073283 · NPPES record last updated Jan 11, 2012
Key facts
- NPI
- 1710073283
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacy 333600000X
- License
- 13679 (OK)
- Practice address
- 307 North Broadway
Poteau, OK 74953 - Phone
- (918) 647-2349
- Fax
- (918) 647-2359
- NPI assigned
- Oct 4, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13679 | OK | MD | Pharmacy |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Acute Care Hospital | 282NR1301X | 13679 | OK | |
| Pharmacy | 333600000X | 13679 | OK | Yes |
Addresses
Primary practice location
307 North Broadway
Poteau, OK 74953
Mailing address
2403 Cardinal Lane
Poteau, OK 74953-0001
Phone (918) 647-2349
Other providers in Poteau, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 11, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.