Provider Demographics
NPI:1477535409
Name:HOUCK, WARD VAUGHN (MD)
Entity Type:Individual
Prefix:DR
First Name:WARD
Middle Name:VAUGHN
Last Name:HOUCK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:300 20TH AVE N STE 403
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-5180
Mailing Address - Country:US
Mailing Address - Phone:615-628-4728
Mailing Address - Fax:615-284-7501
Practice Address - Street 1:1800 MEDICAL CENTER PKWY STE 440
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129
Practice Address - Country:US
Practice Address - Phone:615-867-1940
Practice Address - Fax:615-867-1941
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA80213208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ008883Medicaid
GA33BDBHSMedicare ID - Type Unspecified