# KIRK HOWARD OD PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Family Vision Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114090875
- **Authorized official:** DR. CHARLES KIRK HOWARD OD (OWNER)
- **Authorized official phone:** (850) 682-4014

## Contact information

- **Practice address:** 2491 S FERDON BLVD, CRESTVIEW, FL 32536
- **Practice address phone:** (850) 682-4014
- **Practice address fax:** (850) 682-0387
- **Mailing address:** 2491 S FERDON BLVD, CRESTVIEW, FL 32536
- **Mailing address phone:** (850) 682-4014
- **Mailing address fax:** (850) 682-0387

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | — | NULL | Yes |
| 152W00000X | Optometrist | — | — | Yes |

## Other

- **Enumeration date:** 11/17/2006
- **Last updated:** 03/27/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 21836 | BCBS | — |