Basic Information
| Provider Information | |||||||||
| NPI: | 1689613473 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOWARD | ||||||||
| FirstName: | DONNELLY | ||||||||
| MiddleName: | B | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3929 AIRPORT BLVD # 1 | ||||||||
| Address2: | |||||||||
| City: | MOBILE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 366091987 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2514705842 | ||||||||
| FaxNumber: | 2514705809 | ||||||||
| Practice Location | |||||||||
| Address1: | 75 S UNIVERSITY BLVD | ||||||||
| Address2: | |||||||||
| City: | MOBILE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 366083271 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2516605787 | ||||||||
| FaxNumber: | 2514607923 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/06/2006 | ||||||||
| LastUpdateDate: | 05/05/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/05/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 25493 | AL | N | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | 25493 | AL | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 009933117 | 05 | AL | MEDICAID | 009933888 | 05 | AL | MEDICAID | 1689613473 | 01 | AL | TRICARE SOUTH | OTHER | 515-30686 | 01 | AL | BCBS | OTHER | 009933116 | 05 | AL | MEDICAID | 04-01555 | 01 | AL | UNITED HEALTH CARE | OTHER | 51531245 | 01 | AL | BLUE CROSS | OTHER | 510-04037 | 01 | AL | BCBS | OTHER | 009937938 | 05 | AL | MEDICAID | 07877352 | 05 | MS | MEDICAID | 51531572 | 01 | AL | BLUE CROSS | OTHER |