Provider Demographics
NPI:1487609541
Name:HOWARD, WILLARD HOWE III (DO)
Entity type:Individual
Prefix:DR
First Name:WILLARD
Middle Name:HOWE
Last Name:HOWARD
Suffix:III
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:WILLARD
Other - Middle Name:HOWE
Other - Last Name:HOWARD
Other - Suffix:III
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:1310 CHATTIE DR
Mailing Address - Street 2:
Mailing Address - City:CENTERTON
Mailing Address - State:AR
Mailing Address - Zip Code:72719-7305
Mailing Address - Country:US
Mailing Address - Phone:479-366-3282
Mailing Address - Fax:
Practice Address - Street 1:1310 CHATTIE DR
Practice Address - Street 2:
Practice Address - City:CENTERTON
Practice Address - State:AR
Practice Address - Zip Code:72719-7305
Practice Address - Country:US
Practice Address - Phone:479-366-3282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-0976207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891177XMedicaid
NC1177XOtherBLUE CROSS
NC891177XMedicaid
NCG43735Medicare UPIN