MEDICARE: EDWARD HOWARD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	5642	OK

General Provider Information

NPI Number	:	1417476110
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDWARD HOWARD

Provider Business Mailing Address
First Line	:	4301 WILSON ST
Second Line	:
City	:	LAWTON
State	:	OK
Zip	:	73503-4472
Country	:	US
Telephone Number	:	580-558-0980
Fax Number	:

Provider Business Practice Location Address
First Line	:	3161 HOSKINS RD BLDG 3161
Second Line	:
City	:	LAWTON
State	:	OK
Zip	:	73503-4462
Country	:	US
Telephone Number	:	580-558-0980
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2017
Last Update Date	:	03/06/2025

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Directions to “ EDWARD HOWARD ” Practice Location

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