Basic Information
| Provider Information | |||||||||
| NPI: | 1205010071 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | W J HOWELL MD PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2257 TAYLOR RD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | MONTGOMERY | ||||||||
| State: | AL | ||||||||
| PostalCode: | 361177790 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3342709914 | ||||||||
| FaxNumber: | 3342703195 | ||||||||
| Practice Location | |||||||||
| Address1: | 995 9TH AVE SW | ||||||||
| Address2: | |||||||||
| City: | BESSEMER | ||||||||
| State: | AL | ||||||||
| PostalCode: | 350224527 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2054817000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/28/2007 | ||||||||
| LastUpdateDate: | 06/27/2013 | ||||||||
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| AuthorizedOfficialLastName: | HOWELL | ||||||||
| AuthorizedOfficialFirstName: | WILLIAM | ||||||||
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| AuthorizedOfficialTitleorPosition: | M.D./OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2059365720 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 00005833 | AL | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
ID Information
| ID | Type | State | Issuer | Description | 051032958 | 01 | AL | BLUE CROSS BLUE SHIELD | OTHER | 260039662 | 01 | AL | RR MEDICARE | OTHER | 000032958 | 05 | AL | MEDICAID |