Provider Demographics
NPI:1497919435
Name:MICHAEL TODD HOWARD MD LLC
Entity Type:Organization
Organization Name:MICHAEL TODD HOWARD MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-430-5513
Mailing Address - Street 1:3525 RILEY ST
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70805-2746
Mailing Address - Country:US
Mailing Address - Phone:225-356-2004
Mailing Address - Fax:225-356-8008
Practice Address - Street 1:3525 RILEY ST
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70805-2746
Practice Address - Country:US
Practice Address - Phone:225-356-2004
Practice Address - Fax:225-356-8008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-17
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA200343261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1533904Medicaid
LAG60619Medicare UPIN