Provider Demographics
NPI:1508046848
Name:HOWTON, MARCUS L (RSA, CSA)
Entity Type:Individual
Prefix:MR
First Name:MARCUS
Middle Name:L
Last Name:HOWTON
Suffix:
Gender:M
Credentials:RSA, CSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1802 N DIVISION ST
Mailing Address - Street 2:SUITE 109
Mailing Address - City:MORRIS
Mailing Address - State:IL
Mailing Address - Zip Code:60450-1182
Mailing Address - Country:US
Mailing Address - Phone:815-513-3654
Mailing Address - Fax:877-924-7754
Practice Address - Street 1:1802 N DIVISION ST
Practice Address - Street 2:SUITE 109
Practice Address - City:MORRIS
Practice Address - State:IL
Practice Address - Zip Code:60450-1182
Practice Address - Country:US
Practice Address - Phone:815-513-3654
Practice Address - Fax:877-924-7754
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-04
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X, 363AS0400X
IL238.000207246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
Yes174400000XOther Service ProvidersSpecialist
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical