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General NPI Number Information
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NPI Number | 1447743257
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Entity Type | Individual
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Provider Name | KORBY JON HOWELL PA-C
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Gender | Male
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Dates
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Enumeration Date | 06/07/2018
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | 401 2ND AVE
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City | ROLETTE
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State | ND
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Zip | 58366
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Country | US
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Telephone | 701-246-3391
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Fax | 701-246-3392
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Provider Business Mailing Address
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Address Line | 401 2ND AVE
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City | ROLETTE
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State | ND
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Zip | 58366
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Country | US
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Telephone | 701-246-3391
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Fax | 701-246-3392
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 5601009066
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License Number State | MI
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