Provider Demographics
NPI:1619984960
Name:HOWARD, STEVEN RAY (DC)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:RAY
Last Name:HOWARD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 HIGHWAY 15 NORTH
Mailing Address - Street 2:P O BOX 994
Mailing Address - City:JACKSON
Mailing Address - State:KY
Mailing Address - Zip Code:41339-0994
Mailing Address - Country:US
Mailing Address - Phone:606-666-0009
Mailing Address - Fax:606-666-0095
Practice Address - Street 1:1725 HIGHWAY 15 N
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:KY
Practice Address - Zip Code:41339-9405
Practice Address - Country:US
Practice Address - Phone:606-666-0009
Practice Address - Fax:606-666-0095
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4577111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000112949OtherANTHEM
KY85000305Medicaid
KY85000305Medicaid
KY6089201Medicare ID - Type UnspecifiedKENTUCKY MEDICARE