Provider Demographics
NPI:1750823860
Name:HOWARDS, JASON BERNARD (PA-C, LAT)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:BERNARD
Last Name:HOWARDS
Suffix:
Gender:M
Credentials:PA-C, LAT
Other - Prefix:
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Mailing Address - Street 1:7974 UW HEALTH CT
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-5531
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4602 EASTPARK BLVD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53718-2002
Practice Address - Country:US
Practice Address - Phone:608-265-3207
Practice Address - Fax:608-662-4545
Is Sole Proprietor?:No
Enumeration Date:2016-11-08
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI11522255A2300X
WI3812 - 23363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1152OtherNATA-BOC LICENSED ATHLETIC TRAINER