1487609541 NPI number — DR. WILLARD HOWE HOWARD III DO

Table of content: DR. WILLARD HOWE HOWARD III DO (NPI 1487609541)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487609541 NPI number — DR. WILLARD HOWE HOWARD III DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOWARD
Provider First Name:
WILLARD
Provider Middle Name:
HOWE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
III
Provider Credential Text:
DO
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HOWARD
Provider Other First Name:
WILLARD
Provider Other Middle Name:
HOWE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
III
Provider Other Credential Text:
DO
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1487609541
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/05/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1310 CHATTIE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CENTERTON
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72719-7305
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
479-366-3282
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1310 CHATTIE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CENTERTON
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72719-7305
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
479-366-3282
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/24/2006

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: 207Q00000X , with the licence number:  E-0976 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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