Provider Demographics
NPI:1598767071
Name:HOWARD, GEORGE ALBERT III (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:ALBERT
Last Name:HOWARD
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:299 DOCTORS DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-6321
Mailing Address - Country:US
Mailing Address - Phone:910-577-1171
Mailing Address - Fax:910-577-5112
Practice Address - Street 1:299 DOCTORS DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-6321
Practice Address - Country:US
Practice Address - Phone:910-577-1171
Practice Address - Fax:910-577-5112
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-15
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC300442085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0174COtherBCBS OF NC
NC8944142Medicaid
NC890174CMedicaid
NC44142OtherBCBS OF NC
NC890174CMedicaid
NC890174CMedicaid