Provider Demographics
NPI:1972593887
Name:HOUSER, RICHARD A (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:A
Last Name:HOUSER
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:PO BOX 505
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:CT
Mailing Address - Zip Code:06444-0505
Mailing Address - Country:US
Mailing Address - Phone:860-426-1536
Mailing Address - Fax:860-628-7648
Practice Address - Street 1:178 FARMINGBERRY DR.
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:CT
Practice Address - Zip Code:06444
Practice Address - Country:US
Practice Address - Phone:860-426-1536
Practice Address - Fax:860-628-7648
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-24
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0230622084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001230622Medicaid
E27010Medicare UPIN
CT001230622Medicaid
CT260004442Medicare PIN