Healthcare Provider Details

I. General information

NPI: 1780694893
Provider Name (Legal Business Name): JOHN HOWARD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 09/28/2020
Certification Date: 09/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

395 WESTFIELD RD
NOBLESVILLE IN
46060-1425
US

IV. Provider business mailing address

PO BOX 775985
CHICAGO IL
60677-5985
US

V. Phone/Fax

Practice location:
  • Phone: 317-802-3146
  • Fax: 317-870-0499
Mailing address:
  • Phone: 317-770-6900
  • Fax: 317-770-6911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number01053159
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: