Provider Demographics
NPI:1659376333
Name:HOWARD, BARBARA ELAINE (MD)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ELAINE
Last Name:HOWARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3241 W TRUMAN BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65109
Mailing Address - Country:US
Mailing Address - Phone:573-635-9668
Mailing Address - Fax:573-635-0018
Practice Address - Street 1:3241 W TRUMAN BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65109
Practice Address - Country:US
Practice Address - Phone:573-635-9668
Practice Address - Fax:573-635-0018
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-17
Last Update Date:2009-09-09
Deactivation Date:2006-03-20
Deactivation Code:
Reactivation Date:2006-03-24
Provider Licenses
StateLicense IDTaxonomies
MO2000146098208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO431885843OtherFEIN
MO129665OtherBCBS
MO205008501Medicaid
MO431885843OtherFEIN
MO205008501Medicaid