Provider Demographics
NPI:1649401225
Name:HOWELL, AMY HUCKABY (OD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:HUCKABY
Last Name:HOWELL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1636
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37401-1636
Mailing Address - Country:US
Mailing Address - Phone:423-265-4306
Mailing Address - Fax:423-265-4404
Practice Address - Street 1:537 MARKET ST
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37402-1252
Practice Address - Country:US
Practice Address - Phone:423-265-4306
Practice Address - Fax:423-265-4404
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-30
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT002542152W00000X
TNOD2900152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist