Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 51145 | GA |
N | 207YS0123X | Facial Plastic Surgeon | 051145 | GA |
NPI | 1427041631 |
---|---|
Provider Name | Mr. Raymond Howard III |
First Address | Rome, GA 30165-1494 |
Second Address | Rome, GA 30165-1494 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2005 |
Last Update Date | 20/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00941399A | (05) | GA |