Provider Demographics
NPI:1336523240
Name:HOWARD, JOSEPH KENNETH (AA)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:KENNETH
Last Name:HOWARD
Suffix:
Gender:
Credentials:AA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2515 NORTHEAST EXPY NE
Mailing Address - Street 2:APT F9
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30345-2501
Mailing Address - Country:US
Mailing Address - Phone:706-601-0832
Mailing Address - Fax:
Practice Address - Street 1:2515 NORTHEAST EXPY NE
Practice Address - Street 2:APT F9
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30345-2501
Practice Address - Country:US
Practice Address - Phone:706-601-0832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-10
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2000-00036367H00000X
367H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant