1932179942 NPI number — DR. ANGELA CAROL HOWELL O.D.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932179942 NPI number — DR. ANGELA CAROL HOWELL O.D.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

HOWELL

Provider First Name:

ANGELA

Provider Middle Name:

CAROL

Provider Name Prefix Text:

DR.

Provider Name Suffix Text:

Provider Credential Text:

O.D.

Provider Gender Code:

F

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:

1932179942

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

12/08/2023

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

3708 ALABAMA RD

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

JONESBORO

Provider Business Mailing Address State Name:

AR

Provider Business Mailing Address Postal Code:

72405-9706

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

870-598-4002

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

2100 E HIGHLAND DR STE 100

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

JONESBORO

Provider Business Practice Location Address State Name:

AR

Provider Business Practice Location Address Postal Code:

72401-5383

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

870-336-9090

Provider Business Practice Location Address Fax Number:

Provider Enumeration Date:

01/23/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 152W00000X , with the licence number:  T003012 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 152W00000X , with the licence number: 2863 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 152WP0200X , with the licence number: 2384 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 152W00000X , with the licence number: 2384 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 312904709 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
• Identifier: 312904717 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
• Identifier: 5G858 . This is a "MEDICARE PTAN" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
• Identifier: 140020722 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
• Identifier: 312901725 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
• Identifier: 118130722 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
• Identifier: 1635570 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
• Identifier: 2863 . This is a "OD" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
• Identifier: 410037446 . This is a "RAILROAD MEDICARE PTAN" identifier . This identifiers is of the category "OTHER".