Provider Demographics
NPI:1508884818
Name:HOWELL, TAY SHA LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:TAY SHA
Middle Name:LYNN
Last Name:HOWELL
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 1:1300 E 9TH ST STE 4
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-5760
Mailing Address - Country:US
Mailing Address - Phone:405-251-6782
Mailing Address - Fax:405-653-1623
Practice Address - Street 1:1300 E 9TH ST STE 4
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-5760
Practice Address - Country:US
Practice Address - Phone:405-251-6782
Practice Address - Fax:405-653-1623
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK18962207P00000X, 207PE0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0005XAllopathic & Osteopathic PhysiciansEmergency MedicineUndersea and Hyperbaric Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100107110BMedicaid