Basic Information
| Provider Information | |||||||||
| NPI: | 1003244708 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOWELL | ||||||||
| FirstName: | MATTHEW | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | O.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15933 CLAYTON RD STE 201 | ||||||||
| Address2: | |||||||||
| City: | BALLWIN | ||||||||
| State: | MO | ||||||||
| PostalCode: | 630112172 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6362004393 | ||||||||
| FaxNumber: | 6365270838 | ||||||||
| Practice Location | |||||||||
| Address1: | 8548 BEECHMONT AVE | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452554708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5134740122 | ||||||||
| FaxNumber: | 5134741376 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/16/2013 | ||||||||
| LastUpdateDate: | 08/11/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 5001 | MA | Y | Eye and Vision Services Providers | Optometrist | 152WC0802X | 5001 | MA | N | Eye and Vision Services Providers | Optometrist | Corneal and Contact Management | 152W00000X | 6261 | OH | N | Eye and Vision Services Providers | Optometrist |
No ID Information.