Provider Demographics
NPI:1750481875
Name:ANGELA HOWELL OD PA
Entity Type:Organization
Organization Name:ANGELA HOWELL OD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:CAROL
Authorized Official - Last Name:HOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:O,D
Authorized Official - Phone:870-598-4002
Mailing Address - Street 1:3708 ALABAMA RD
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-9706
Mailing Address - Country:US
Mailing Address - Phone:870-598-4002
Mailing Address - Fax:
Practice Address - Street 1:3000 E HIGHLAND DR STE 609
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-6379
Practice Address - Country:US
Practice Address - Phone:870-336-9090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2384152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR118130722Medicaid
AR5C364Medicare ID - Type UnspecifiedMEDICARE ID