Healthcare Provider Details

I. General information

NPI: 1649965922
Provider Name (Legal Business Name): MACY HOWARD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MACY DIMMETT MD

II. Dates (important events)

Enumeration Date: 04/11/2023
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 MEDICAL CENTER DR
POWDERLY KY
42367-5463
US

IV. Provider business mailing address

1010 MEDICAL CENTER DR
POWDERLY KY
42367-5463
US

V. Phone/Fax

Practice location:
  • Phone: 270-377-1600
  • Fax: 270-377-1684
Mailing address:
  • Phone: 270-377-1600
  • Fax: 270-377-1684

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number61795
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: