Provider Demographics
NPI:1568602779
Name:CARTER, ANDREW KYLE (PA-C)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:KYLE
Last Name:CARTER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6400 S LEWIS AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-1088
Mailing Address - Country:US
Mailing Address - Phone:405-378-2727
Mailing Address - Fax:918-265-1294
Practice Address - Street 1:6400 S LEWIS AVE STE 100
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-1088
Practice Address - Country:US
Practice Address - Phone:405-378-2727
Practice Address - Fax:918-265-1294
Is Sole Proprietor?:No
Enumeration Date:2009-02-27
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK1823363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant