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General NPI Number Information
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NPI Number | 1578761136
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Entity Type | Organization
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Legal Business Name | JASON B. HOWARD, O.D. L.L.C.
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Dates
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Enumeration Date | 07/05/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 120 JILL DR
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City | BEREA
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State | KY
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Zip | 40403-1677
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Country | US
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Telephone | 859-986-3759
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Fax |
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Provider Business Mailing Address
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Address Line | 120 JILL DR
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City | BEREA
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State | KY
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Zip | 40403-1677
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Country | US
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Telephone | 859-986-3759
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST, OWNER
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Name | DR. JASON BRIAN HOWARD
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Credential |
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Telephone | 859-986-3759
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 0043107
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License Number State | KY
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