Provider Demographics
NPI:1841213717
Name:HOWELL, JOHN TRAVIS (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:TRAVIS
Last Name:HOWELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 PATRICIA DR
Mailing Address - Street 2:
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50322-2103
Mailing Address - Country:US
Mailing Address - Phone:515-276-5147
Mailing Address - Fax:
Practice Address - Street 1:7755 HICKMAN RD
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-4511
Practice Address - Country:US
Practice Address - Phone:515-440-0771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2015-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA19551207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA3030700Medicaid
IAA00131Medicare UPIN
IA3030700Medicaid