Provider Demographics
NPI:1982684080
Name:HOWARD, WILLARD HOWE JR (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLARD
Middle Name:HOWE
Last Name:HOWARD
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 739
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-0739
Mailing Address - Country:US
Mailing Address - Phone:479-273-5551
Mailing Address - Fax:479-273-5500
Practice Address - Street 1:903 NW 9TH ST
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-4501
Practice Address - Country:US
Practice Address - Phone:479-273-5551
Practice Address - Fax:479-273-5500
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARC4675207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR101085001Medicaid
ARC68546Medicare UPIN
AR52501Medicare ID - Type Unspecified