Provider Demographics
NPI:1376628693
Name:HOUT, JULIE N (PA)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:N
Last Name:HOUT
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MISS
Other - First Name:JULIE
Other - Middle Name:N
Other - Last Name:HOFFMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:4439 STATE ROUTE 159 STE 210
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-8207
Mailing Address - Country:US
Mailing Address - Phone:740-779-4540
Mailing Address - Fax:740-779-4549
Practice Address - Street 1:4439 STATE ROUTE 159 STE 210
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-8207
Practice Address - Country:US
Practice Address - Phone:740-779-4540
Practice Address - Fax:740-779-4549
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50001824363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0000003840001OtherANTHEM PROVIDER NUMBER
OH0000003840001OtherANTHEM PROVIDER NUMBER
OHHOPA26211Medicare ID - Type Unspecified