Provider Demographics
NPI:1588664288
Name:HARPER, HOWARD DALE (MD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:DALE
Last Name:HARPER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6220
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73506
Mailing Address - Country:US
Mailing Address - Phone:580-536-9300
Mailing Address - Fax:580-536-7900
Practice Address - Street 1:5112 W. GORE BLVD
Practice Address - Street 2:SUITE 3
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-2843
Practice Address - Country:US
Practice Address - Phone:580-536-9300
Practice Address - Fax:580-536-7900
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-26
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK190522085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKF99558Medicare UPIN