Provider Demographics
NPI:1508939729
Name:CARRICK, ANGELA IRENE (DO)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:IRENE
Last Name:CARRICK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ANGIE
Other - Middle Name:IRENE
Other - Last Name:CARRICK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:1804 CANDLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-2276
Mailing Address - Country:US
Mailing Address - Phone:405-408-3223
Mailing Address - Fax:
Practice Address - Street 1:901 N PORTER AVE
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-6404
Practice Address - Country:US
Practice Address - Phone:405-307-1500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2010-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4433207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine