Provider Demographics
NPI:1639190879
Name:GARY L. HOWARD MD PC
Entity Type:Organization
Organization Name:GARY L. HOWARD MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:L
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-665-2002
Mailing Address - Street 1:401 AIRPORT COMMONS DR # 404
Mailing Address - Street 2:
Mailing Address - City:CALERA
Mailing Address - State:AL
Mailing Address - Zip Code:35040-7004
Mailing Address - Country:US
Mailing Address - Phone:205-665-2002
Mailing Address - Fax:205-665-2008
Practice Address - Street 1:401 AIRPORT COMMONS DR # 404
Practice Address - Street 2:
Practice Address - City:CALERA
Practice Address - State:AL
Practice Address - Zip Code:35040-7004
Practice Address - Country:US
Practice Address - Phone:205-665-2002
Practice Address - Fax:205-665-2008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL13355207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051507528Medicaid
ALC73489Medicare UPIN
AL102G705078Medicare PIN
AL051507528Medicaid