MEDICARE: CHRISTOPHER HOWELL PAC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA445	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0007304443	OTHER	KY	AETNA PROVIDER NUMBER
2	000001202079	OTHER	KY	CHA PROVIDER NUMBER
3	000000317659	OTHER	KY	ANTHEM PROVIDER NUMBER

General Provider Information

NPI Number	:	1831195809
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER HOWELL PAC

Provider Business Mailing Address
First Line	:	3125 OLD CROW CT
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40502-2909
Country	:	US
Telephone Number	:	859-509-5594
Fax Number	:

Provider Business Practice Location Address
First Line	:	3125 OLD CROW CT
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40502-2909
Country	:	US
Telephone Number	:	859-509-5594
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2005
Last Update Date	:	08/26/2010

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