Healthcare Provider Details

I. General information

NPI: 1003107863
Provider Name (Legal Business Name): MARSHA K. HOWERTON, MD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2011
Last Update Date: 06/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6465 S YALE AVE SUITE 310
TULSA OK
74136-7823
US

IV. Provider business mailing address

6465 S YALE AVE SUITE 310
TULSA OK
74136-7823
US

V. Phone/Fax

Practice location:
  • Phone: 918-481-2941
  • Fax: 918-481-2942
Mailing address:
  • Phone: 918-481-2941
  • Fax: 918-481-2942

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number16121
License Number StateOK

VIII. Authorized Official

Name: MRS. REGINA RENEE BEACHAM
Title or Position: CREDENTIALER
Credential:
Phone: 918-808-8235