Provider Demographics
NPI:1144559600
Name:HOWELL FAMILY PRACTICE P C
Entity type:Organization
Organization Name:HOWELL FAMILY PRACTICE P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-921-6665
Mailing Address - Street 1:5960 HOWDERSHELL RD STE 106
Mailing Address - Street 2:
Mailing Address - City:HAZELWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63042-4102
Mailing Address - Country:US
Mailing Address - Phone:314-731-3300
Mailing Address - Fax:
Practice Address - Street 1:5960 HOWDERSHELL RD STE 106
Practice Address - Street 2:
Practice Address - City:HAZELWOOD
Practice Address - State:MO
Practice Address - Zip Code:63042-4102
Practice Address - Country:US
Practice Address - Phone:314-731-3300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-12
Last Update Date:2014-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO000000397Medicare PIN