Provider Demographics
NPI:1467456038
Name:CARTER, JOHN NEREUS (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:NEREUS
Last Name:CARTER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 785
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73502-0785
Mailing Address - Country:US
Mailing Address - Phone:580-357-9984
Mailing Address - Fax:580-357-3277
Practice Address - Street 1:110 NW 31ST ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-6100
Practice Address - Country:US
Practice Address - Phone:580-510-7042
Practice Address - Fax:580-510-7044
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2013-08-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK143992086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100117690AMedicaid