Provider Demographics
NPI:1043272982
Name:CARNEY, MICHAEL P (DO)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:P
Last Name:CARNEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 S JACKSON AVE
Mailing Address - Street 2:SUITE 500
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74127-9015
Mailing Address - Country:US
Mailing Address - Phone:918-582-7711
Mailing Address - Fax:
Practice Address - Street 1:802 S JACKSON AVE
Practice Address - Street 2:SUITE 500
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74127-9015
Practice Address - Country:US
Practice Address - Phone:918-582-7711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2009-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1811207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100049420AMedicaid
OKD38250Medicare UPIN