Provider Demographics
NPI:1558319343
Name:HOUCK, RICHARD JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:JAMES
Last Name:HOUCK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1040 SIERRA DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-7240
Mailing Address - Country:US
Mailing Address - Phone:317-528-4262
Mailing Address - Fax:317-865-8327
Practice Address - Street 1:1225 E COOLSPRING AVE
Practice Address - Street 2:SUITE 1A
Practice Address - City:MICHIGAN CITY
Practice Address - State:IN
Practice Address - Zip Code:46360-6312
Practice Address - Country:US
Practice Address - Phone:219-878-5035
Practice Address - Fax:219-878-5002
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2014-12-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01018052207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1558319343OtherNATIONAL
IN100162510Medicaid
IN000000082446OtherANTHEM
IN000000082446OtherANTHEM
IN1558319343OtherNATIONAL