1003858051 NPI number — DR. ANGUS C HOWARD JR. M.D.

Table of content: DR. ANGUS C HOWARD JR. M.D. (NPI 1003858051)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003858051 NPI number — DR. ANGUS C HOWARD JR. M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOWARD
Provider First Name:
ANGUS
Provider Middle Name:
C
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
JR.
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003858051
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/31/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
595 HURRICANE SHOALS RD NW STE 100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAWRENCEVILLE
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30046-8762
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
404-645-7150
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
595 HURRICANE SHOALS RD NW STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAWRENCEVILLE
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30046
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-645-7150
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RN0300X , with the licence number:  030099 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000470401C , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000470401F , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000470401H , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1634458 . This is a "CIGNA" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 000470401G , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 110051099 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000470401E , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3106162 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 000470401A , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 28257 . This is a "BCBS" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 505559 . This is a "AETNA" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 000470401D , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000470401I , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000470401K , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000470401O , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000470401Q , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".




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