Healthcare Provider Details

I. General information

NPI: 1104792092
Provider Name (Legal Business Name): MR. CLAYTON LEN HOWARD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2025
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5101 HARRISBURG RD
JONESBORO AR
72404-8729
US

IV. Provider business mailing address

308 HILLPOINT CV
JONESBORO AR
72401-5981
US

V. Phone/Fax

Practice location:
  • Phone: 870-933-4535
  • Fax:
Mailing address:
  • Phone: 501-725-0379
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOT-A729
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: