Healthcare Provider Details

I. General information

NPI: 1063901098
Provider Name (Legal Business Name): G ELI HOWELL MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2018
Last Update Date: 03/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

971 LAKELAND DR STE 225
JACKSON MS
39216
US

IV. Provider business mailing address

971 LAKELAND DR STE 225
JACKSON MS
39216-4615
US

V. Phone/Fax

Practice location:
  • Phone: 601-308-3900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: G ELI HOWELL II
Title or Position: OWNER
Credential: MD
Phone: 601-308-3900