Healthcare Provider Details

I. General information

NPI: 1164425278
Provider Name (Legal Business Name): SCOTT C HOWARD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 10/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ST. JUDE CHILDREN'S RESEARCH HOSPITAL 262 DANNY THOMAS PLACE
MEMPHIS TN
38105-2794
US

IV. Provider business mailing address

ST. JUDE CHILDREN'S RESEARCH HOSPITAL 262 DANNY THOMAS PLACE
MEMPHIS TN
38105-2794
US

V. Phone/Fax

Practice location:
  • Phone: 901-595-2972
  • Fax: 901-595-2972
Mailing address:
  • Phone: 901-595-2972
  • Fax: 901-595-2972

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number27247
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: