MEDICARE: CHARLES N. HOWELL, JR. PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	152WP0200X	Pediatric Optometrist
2	152WS0006X	Sports Vision Optometrist
3	152WX0102X	Occupational Vision Optometrist
4	152WC0802X	Corneal and Contact Management Optometrist

General Provider Information

NPI Number	:	1548535149
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHARLES N. HOWELL, JR. PA

Provider Business Mailing Address
First Line	:	2115 UNIVERSITY BLVD S STE 1
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-8936
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2115 UNIVERSITY BLVD S STE 1
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-8936
Country	:	US
Telephone Number	:	904-725-2300
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. CHARLES N. HOWELL JR.
Credential	:	O.D., M.ED, P.A.
Telephone Number	:	904-725-2300

Provider Enumeration Date	:	03/14/2012
Last Update Date	:	03/16/2012

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