Provider Demographics
NPI:1790999829
Name:HOUGHTON, JOHN DAVID (DO)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:DAVID
Last Name:HOUGHTON
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:2490 S WOODWORTH LOOP
Mailing Address - Street 2:
Mailing Address - City:PALMER
Mailing Address - State:AK
Mailing Address - Zip Code:99645-7410
Mailing Address - Country:US
Mailing Address - Phone:907-746-7747
Mailing Address - Fax:907-746-7731
Practice Address - Street 1:2490 S WOODWORTH LOOP STE 301
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:AK
Practice Address - Zip Code:99645-7407
Practice Address - Country:US
Practice Address - Phone:907-746-7747
Practice Address - Fax:907-746-7740
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2022-08-26
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Provider Licenses
StateLicense IDTaxonomies
AK155819207V00000X
IA3883207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1708743Medicaid