Provider Demographics
NPI:1750662169
Name:CARMA MEDICAL, PLLC
Entity Type:Organization
Organization Name:CARMA MEDICAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MACK
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:NREMT-P
Authorized Official - Phone:405-513-7771
Mailing Address - Street 1:1218 E 9TH ST
Mailing Address - Street 2:STE 5
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-5952
Mailing Address - Country:US
Mailing Address - Phone:405-513-7771
Mailing Address - Fax:405-513-7725
Practice Address - Street 1:1218 E 9TH ST
Practice Address - Street 2:SUITE 5
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-5952
Practice Address - Country:US
Practice Address - Phone:405-513-7771
Practice Address - Fax:405-513-7725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-31
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0058479363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty