Provider Demographics
NPI:1114925062
Name:CARTER, DAVID SETH (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:SETH
Last Name:CARTER
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1126 W BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:MUSKOGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74401-6246
Mailing Address - Country:US
Mailing Address - Phone:918-682-5584
Mailing Address - Fax:918-682-5585
Practice Address - Street 1:1126 W BROADWAY ST
Practice Address - Street 2:
Practice Address - City:MUSKOGEE
Practice Address - State:OK
Practice Address - Zip Code:74401-6246
Practice Address - Country:US
Practice Address - Phone:918-682-5584
Practice Address - Fax:918-682-5585
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK135231835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1193360001Medicare ID - Type UnspecifiedMEDICARE NUMBER