Provider Demographics
NPI:1598800179
Name:JOHN P. HOUDE, M.D. P.C.
Entity Type:Organization
Organization Name:JOHN P. HOUDE, M.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:HOUDE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:603-542-7666
Mailing Address - Street 1:241 ELM STREET
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:NH
Mailing Address - Zip Code:03743
Mailing Address - Country:US
Mailing Address - Phone:603-542-7666
Mailing Address - Fax:
Practice Address - Street 1:241 ELM STREET
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:NH
Practice Address - Zip Code:03743
Practice Address - Country:US
Practice Address - Phone:603-542-7666
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH11504207X00000X
VT0420010413207X00000X
NH0486P363A00000X
VT0550030669363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1009003OtherVERMONT MEDICAID
NH2972483OtherAETNA
VT710024OtherMVP
VT00058952OtherBLUE CROSS OF VERMONT
VT00059775OtherBLUE CROSS VERMONT
NH10904877OtherUNITED HEALTHCARE
VT602933OtherMVP
NH30203221OtherNEW HAMPSHIRE MEDICAID
NH671950OtherCIGNA
NHP98763Medicare UPIN
NH10904877OtherUNITED HEALTHCARE
NH30203221OtherNEW HAMPSHIRE MEDICAID
NHF75854Medicare UPIN