Provider Demographics
NPI:1548253131
Name:HOWARD, WILLIAM BRECK (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:BRECK
Last Name:HOWARD
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:PO BOX 1020
Mailing Address - Street 2:
Mailing Address - City:PLAINS
Mailing Address - State:MT
Mailing Address - Zip Code:59859-1020
Mailing Address - Country:US
Mailing Address - Phone:406-826-6600
Mailing Address - Fax:406-826-0143
Practice Address - Street 1:1208 6TH AVE
Practice Address - Street 2:
Practice Address - City:SUPERIOR
Practice Address - State:MT
Practice Address - Zip Code:59872-9667
Practice Address - Country:US
Practice Address - Phone:406-826-4506
Practice Address - Fax:406-826-0143
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT33872085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT300134948OtherRR MEDICARE
MT0020150Medicaid
WA1102136Medicaid
P00399528OtherRAILROAD MEDICARE
WA1102136Medicaid
MT300134948OtherRR MEDICARE
E41484Medicare UPIN