Provider Demographics
NPI:1689613473
Name:HOWARD, DONNELLY B (MD)
Entity Type:Individual
Prefix:
First Name:DONNELLY
Middle Name:B
Last Name:HOWARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
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Mailing Address - Street 1:3929 AIRPORT BLVD # 1
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36609-1987
Mailing Address - Country:US
Mailing Address - Phone:251-470-5842
Mailing Address - Fax:251-470-5809
Practice Address - Street 1:75 S UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-3271
Practice Address - Country:US
Practice Address - Phone:251-660-5787
Practice Address - Fax:251-460-7923
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL25493208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009933117Medicaid
AL009933888Medicaid
AL1689613473OtherTRICARE SOUTH
AL515-30686OtherBCBS
AL009933116Medicaid
AL04-01555OtherUNITED HEALTH CARE
AL51531245OtherBLUE CROSS
AL510-04037OtherBCBS
AL009937938Medicaid
MS07877352Medicaid
AL51531572OtherBLUE CROSS
AL51531572OtherBLUE CROSS
AL51531245OtherBLUE CROSS
I14931Medicare UPIN
MS07877352Medicaid