Provider Demographics
NPI:1003107863
Name:MARSHA K. HOWERTON, MD, PC
Entity Type:Organization
Organization Name:MARSHA K. HOWERTON, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALER
Authorized Official - Prefix:MRS
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:BEACHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-808-8235
Mailing Address - Street 1:6465 S YALE AVE
Mailing Address - Street 2:SUITE 310
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-7823
Mailing Address - Country:US
Mailing Address - Phone:918-481-2941
Mailing Address - Fax:918-481-2942
Practice Address - Street 1:6465 S YALE AVE
Practice Address - Street 2:SUITE 310
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-7823
Practice Address - Country:US
Practice Address - Phone:918-481-2941
Practice Address - Fax:918-481-2942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-28
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK16121207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100113070AMedicaid
OK100113070AMedicaid