Basic Information
| Provider Information | |||||||||
| NPI: | 1932369584 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOWARD | ||||||||
| FirstName: | THOMAS | ||||||||
| MiddleName: | C | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 227500 RIB MOUNTAIN DR STE 200 | ||||||||
| Address2: | |||||||||
| City: | WAUSAU | ||||||||
| State: | WI | ||||||||
| PostalCode: | 544015052 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7158702162 | ||||||||
| FaxNumber: | 7158702123 | ||||||||
| Practice Location | |||||||||
| Address1: | 227500 RIB MOUNTAIN DR STE 200 | ||||||||
| Address2: | |||||||||
| City: | WAUSAU | ||||||||
| State: | WI | ||||||||
| PostalCode: | 544015052 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7158702162 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2008 | ||||||||
| LastUpdateDate: | 09/08/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/08/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208200000X | 73216-20 | WI | Y | Allopathic & Osteopathic Physicians | Plastic Surgery |
No ID Information.