Healthcare Provider Details

I. General information

NPI: 1023004652
Provider Name (Legal Business Name): PRESTON B HOWERTON DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2005
Last Update Date: 03/05/2024
Certification Date: 03/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2305 SOUTH 65 HIGHWAY
MARSHALL MO
65340-3702
US

IV. Provider business mailing address

2305 SOUTH 65 HIGHWAY
MARSHALL MO
65340-3702
US

V. Phone/Fax

Practice location:
  • Phone: 660-886-7431
  • Fax: 660-831-3361
Mailing address:
  • Phone: 660-886-7431
  • Fax: 660-831-3314

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number2005029307
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2005029307
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code2083A0100X
TaxonomyAerospace Medicine Physician
License Number2005029307
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: