Provider Demographics
NPI:1982790382
Name:HOWELL, GREGORY (MD)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:
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:PO BOX 1437
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34478-1437
Mailing Address - Country:US
Mailing Address - Phone:352-732-7095
Mailing Address - Fax:352-732-0477
Practice Address - Street 1:1901 SE 18 AVE BUILDING 400
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471
Practice Address - Country:US
Practice Address - Phone:352-732-7095
Practice Address - Fax:352-732-0477
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2009-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00335832084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0651753000Medicaid
FL209385OtherAVMED
FLP00397230OtherRR MEDICARE
FL42148XMedicare PIN
FLD54781Medicare UPIN