Provider Demographics
NPI:1346243755
Name:WOODWARD, HOWARD RANDAL (MD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:RANDAL
Last Name:WOODWARD
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 1:13616 CALIFORNIA ST
Mailing Address - Street 2:STE 100
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-5335
Mailing Address - Country:US
Mailing Address - Phone:402-496-0404
Mailing Address - Fax:402-496-0517
Practice Address - Street 1:13616 CALIFORNIA ST
Practice Address - Street 2:STE 100
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-5335
Practice Address - Country:US
Practice Address - Phone:402-496-0404
Practice Address - Fax:402-496-0517
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE14918207XS0117X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA2902981Medicaid
NE01623OtherBCBS
NE47081304012Medicaid
NE200031846OtherRAILROAD MEDICARE
NE01623OtherBCBS
NE47081304012Medicaid