Provider Demographics
NPI:1164504908
Name:HOUSER, VICTOR C III (MD)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:C
Last Name:HOUSER
Suffix:III
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 1:355 1ST AVENUE WEST N
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-3906
Mailing Address - Country:US
Mailing Address - Phone:406-755-6200
Mailing Address - Fax:406-755-6208
Practice Address - Street 1:355 1ST AVENUE WEST N
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3906
Practice Address - Country:US
Practice Address - Phone:406-755-6200
Practice Address - Fax:406-755-6208
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT70072084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0047866Medicaid
MTF15599Medicare UPIN