Healthcare Provider Details

I. General information

NPI: 1497799118
Provider Name (Legal Business Name): CANDACE MICHELLE HOWARD-CLAUDIO M.D., PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CANDACE MICHELLE HOWARD M.D., PH.D.

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 12/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 N STATE ST
JACKSON MS
39216-4500
US

IV. Provider business mailing address

2500 N STATE ST
JACKSON MS
39216-4500
US

V. Phone/Fax

Practice location:
  • Phone: 601-984-2538
  • Fax:
Mailing address:
  • Phone: 601-984-2538
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number01607
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number40661
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number23960
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: