Provider Demographics
NPI:1568783439
Name:HOUGHTON, ADAM D (MD)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:D
Last Name:HOUGHTON
Suffix:
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 1:9 HEARTLAND DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61704-7732
Mailing Address - Country:US
Mailing Address - Phone:309-663-7642
Mailing Address - Fax:309-663-8359
Practice Address - Street 1:9 HEARTLAND DR
Practice Address - Street 2:SUITE C
Practice Address - City:BLOOMINGTON
Practice Address - State:IL
Practice Address - Zip Code:61704-7732
Practice Address - Country:US
Practice Address - Phone:309-663-7642
Practice Address - Fax:309-663-8359
Is Sole Proprietor?:No
Enumeration Date:2010-06-15
Last Update Date:2014-05-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN11015561A207Q00000X
IL036.132740207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine