Provider Demographics
NPI:1316008675
Name:HOWARD, WILLIAM ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ROBERT
Last Name:HOWARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:400 FAIRVIEW AVE
Mailing Address - Street 2:SUITE 16
Mailing Address - City:PONCA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:74601-1920
Mailing Address - Country:US
Mailing Address - Phone:580-762-8324
Mailing Address - Fax:580-762-2581
Practice Address - Street 1:400 FAIRVIEW AVE
Practice Address - Street 2:SUITE 16
Practice Address - City:PONCA CITY
Practice Address - State:OK
Practice Address - Zip Code:74601-1920
Practice Address - Country:US
Practice Address - Phone:580-762-8324
Practice Address - Fax:580-762-2581
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OKOK10717207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS582628OtherBCBS-KS
KS582628OtherBCBS-KS