Provider Demographics
NPI:1083158422
Name:CARTER, GARRETT DANIEL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:GARRETT
Middle Name:DANIEL
Last Name:CARTER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2248 COUNTY ROAD 1280
Mailing Address - Street 2:
Mailing Address - City:BLANCHARD
Mailing Address - State:OK
Mailing Address - Zip Code:73010-3133
Mailing Address - Country:US
Mailing Address - Phone:405-613-5825
Mailing Address - Fax:
Practice Address - Street 1:13503 S SANTA FE AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73170-7314
Practice Address - Country:US
Practice Address - Phone:405-300-6418
Practice Address - Fax:405-300-6417
Is Sole Proprietor?:No
Enumeration Date:2016-12-05
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK17027183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist