Provider Demographics
NPI:1699730150
Name:HOWELL, GEORGE ELI II (MD)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:ELI
Last Name:HOWELL
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:971 LAKELAND DR
Mailing Address - Street 2:SUITE 315
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39216-4643
Mailing Address - Country:US
Mailing Address - Phone:601-981-2525
Mailing Address - Fax:601-981-3152
Practice Address - Street 1:971 LAKELAND DR
Practice Address - Street 2:SUITE 315
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-4643
Practice Address - Country:US
Practice Address - Phone:601-981-2525
Practice Address - Fax:601-981-3152
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2008-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL238742086S0122X
MS073162086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000000642Medicaid
MS0124911Medicaid
C48141Medicare UPIN
AL51500642Medicare ID - Type Unspecified