Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 10511 | OK |
Y | 207XS0106X | Orthopaedic Hand Surgeon | 10511 | OK |
NPI | 1033117312 |
---|---|
Provider Name | Thomas Craddock Howard III |
First Address | Oklahoma City, OK 73114-7408 |
Second Address | Oklahoma City, OK 73114 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2005 |
Last Update Date | 09/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100141350A | (05) | OK |
200015516 | RAILROAD MEDICARE (01) | OK |
730714291-021 | BCBS OF OKLAHOMA (01) | OK |
D39221 | (02) |