Provider Demographics
NPI:1073586830
Name:HOUGAN, PAUL HOWARD (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:HOWARD
Last Name:HOUGAN
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 CROSS ST
Mailing Address - Street 2:
Mailing Address - City:BIG STONE CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57216-8237
Mailing Address - Country:US
Mailing Address - Phone:605-541-1140
Mailing Address - Fax:605-541-0109
Practice Address - Street 1:700 N MONROE ST
Practice Address - Street 2:
Practice Address - City:MINNEOTA
Practice Address - State:MN
Practice Address - Zip Code:56264-9237
Practice Address - Country:US
Practice Address - Phone:507-872-5308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2076225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN236065OtherARAZ
MNHP43928OtherHEALTH PARTNERS IND #
MN462220100Medicaid
MN116113OtherUCARE IND PROVIDER #
MN6400059OtherMEDICA IND PROV #
MN8B434HOOtherBCBS IND PROVIDER #
MN6400059OtherMEDICA IND PROV #