1598800179 NPI number — JOHN P. HOUDE, M.D. P.C.

Table of content: (NPI 1598800179)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598800179 NPI number — JOHN P. HOUDE, M.D. P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JOHN P. HOUDE, M.D. P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1598800179
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/07/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
241 ELM STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLAREMONT
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03743
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-542-7666
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
241 ELM STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLAREMONT
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03743
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-542-7666
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/21/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HOUDE
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
P
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
603-542-7666

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X , with the licence number:  11504 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207X00000X , with the licence number: 0420010413 , registered in the state of VT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363A00000X , with the licence number: 0486P , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363A00000X , with the licence number: 0550030669 , registered in the state of VT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1009003 . This is a "VERMONT MEDICAID" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".
  • Identifier: 2972483 . This is a "AETNA" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 710024 . This is a "MVP" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".
  • Identifier: 00058952 . This is a "BLUE CROSS OF VERMONT" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".
  • Identifier: 00059775 . This is a "BLUE CROSS VERMONT" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".
  • Identifier: 10904877 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 602933 . This is a "MVP" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".
  • Identifier: 30203221 . This is a "NEW HAMPSHIRE MEDICAID" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 671950 . This is a "CIGNA" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com