Provider Demographics
NPI:1689682841
Name:HOUGHTON COLLEGE STUDENT HEALTH CENTER
Entity Type:Organization
Organization Name:HOUGHTON COLLEGE STUDENT HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUBAKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-567-9483
Mailing Address - Street 1:PO BOX 5199
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79608-5199
Mailing Address - Country:US
Mailing Address - Phone:866-890-6390
Mailing Address - Fax:325-437-8390
Practice Address - Street 1:9789 CR 35
Practice Address - Street 2:
Practice Address - City:HOUGHTON
Practice Address - State:NY
Practice Address - Zip Code:14744
Practice Address - Country:US
Practice Address - Phone:585-567-9483
Practice Address - Fax:585-567-4303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty