Provider Demographics
NPI:1457884280
Name:FERNANDES, CARLTON JOHN (MD)
Entity type:Individual
Prefix:DR
First Name:CARLTON
Middle Name:JOHN
Last Name:FERNANDES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3400 W TECUMSEH RD STE 101
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-1810
Mailing Address - Country:US
Mailing Address - Phone:405-515-0649
Mailing Address - Fax:405-360-3769
Practice Address - Street 1:3400 W TECUMSEH RD STE 101
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-1810
Practice Address - Country:US
Practice Address - Phone:405-515-0649
Practice Address - Fax:405-360-3769
Is Sole Proprietor?:No
Enumeration Date:2017-04-08
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK32947207X00000X
IL036.160526207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery