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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Wednesday, December 18, 2024 6:43 PM CST
Next Update: Thursday, December 19, 2024 2:50 AM CST

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CARPENTER, CARY LEE       
This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.
Practice Address: 15679 NE 23RD STREET
CHOCTAW OK 73020

Address last updated on 8/22/2024
Phone #: (405) 390-9600
Fax #: (405) 390-9400
County: OKLAHOMA
License: 18237
Dated: 9/11/1992
Expires: 9/1/2025
Training Issued: 7/2/1992
Training Expires: 6/30/1993
License Type: Medical Doctor
Specialty: Family Medicine
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: YES
Medical School: Univ Of Ok Coll Of Med, Oklahoma City Ok 73190
Graduated: 6 / 1991
CME Year: 2027
Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Certifications:
New Patients: Yes
Medicaid: Yes
Medicare: Yes
   
HMO/PPO: Aetna HMO
Aetna PPO
Beechstreet PPO
Blue Cross Blue Shield-Blue Preferred
Blue Cross Blue Shield-Blue Traditional
Blue Cross Blue Shield-Plan 65 Select
BlueChoice PPO
BlueLincs HMO
Champ VA
CIGNA HMO
CIGNA PPO
CommunityCare HMO, Inc
Coventry Health Care National Network
First Health
Global Health HMO
Great West Healthcare
Guidestar Health Systems
HealthChoice
Humana ChoiceCare
Humana Medicare Advantage PPO
Humana Tricare/PGBA
Medicare Blue
Multiplan PPO
Oklahoma Health Network PPO
OSMA Health (formerly Plico PPO)
Pacificare Commercial HMO
PacifiCare of Oklahoma, Inc
PHCS (Private Healthcare Systems)
Preferred Community Choice
Private Healthcare Systems (PHCS)
Prudential Health Care Plan, Inc
Railroad Medicare
Secure Horizons HMO
SoonerCare HMO
SoonerCare PPO
Tricare for Life
Tricare Standard
UniCare Health Plans of Oklahoma
United Healthcare Choice
United Healthcare EPO
United Healthcare HMO
United Healthcare Options PPO
Hospital Privileges: Atoka Memorial Hospital
Atoka, OK
INTEGRIS Baptist Medical Center
Oklahoma City, OK
SSM Health St. Anthony Hospital - OKC
Oklahoma City, OK
SSM St Anthony Midwest Regional Medical Center
Midwest City, OK
Locations: Hours: Languages:
15679 NE 23RD STREET
CHOCTAW OK 73020

Phone #: (405) 390-9600
Fax #: (405) 390-9400
Mon: 8:00AM - 5:00PM
Tue: 8:00AM - 5:00PM
Wed: 8:00AM - 12:00PM
Thu: 8:00AM - 5:00PM
Fri: 8:00AM - 5:00PM
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
LEA BRYAN APRN 129002
KIMBERLY ANN DAVIS AT 158
AMANDA FITE APRN 14342
ANTON TERRELL HICKS PA 4906
JOEL GEORGE SAJAN PA 4936
BILLY GRANT SANDERS PA 1561

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