Healthcare Provider Details

I. General information

NPI: 1396760302
Provider Name (Legal Business Name): ROBERT FREMONT HOWARD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 05/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1245 S. UTICA AVE. 3RD FLOOR
TULSA OK
74104-4214
US

IV. Provider business mailing address

1245 S. UTICA AVE.
TULSA OK
74104-4214
US

V. Phone/Fax

Practice location:
  • Phone: 918-579-2590
  • Fax: 918-579-2599
Mailing address:
  • Phone: 918-579-2590
  • Fax: 918-579-2599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number14764
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: