Provider Demographics
NPI:1649253402
Name:HOWARD, BRIAN C (MD)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:C
Last Name:HOWARD
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 1:6585 S YALE AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-8384
Mailing Address - Country:US
Mailing Address - Phone:918-481-2767
Mailing Address - Fax:
Practice Address - Street 1:13616 E 103RD ST N
Practice Address - Street 2:
Practice Address - City:OWASSO
Practice Address - State:OK
Practice Address - Zip Code:74055-4586
Practice Address - Country:US
Practice Address - Phone:918-481-2767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-25
Last Update Date:2010-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK13767207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100112200AMedicaid
OK100112200AMedicaid