Provider Demographics
NPI:1538258975
Name:HOWELL, GEORGE L (MD)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:L
Last Name:HOWELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 DAVIS STREET
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39301-5708
Mailing Address - Country:US
Mailing Address - Phone:601-693-0118
Mailing Address - Fax:601-553-8175
Practice Address - Street 1:105 FELIX LONG ST
Practice Address - Street 2:
Practice Address - City:STARKVILLE
Practice Address - State:MS
Practice Address - Zip Code:39759-8608
Practice Address - Country:US
Practice Address - Phone:662-323-2911
Practice Address - Fax:601-553-8175
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS04051207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00010661Medicaid
B29916Medicare UPIN
MS080003826Medicare PIN