Provider Demographics
NPI:1295732758
Name:HOUGH, KEITH D (MD)
Entity type:Individual
Prefix:
First Name:KEITH
Middle Name:D
Last Name:HOUGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:14 BELLE RIVER CIR
Mailing Address - Street 2:
Mailing Address - City:MAUMELLE
Mailing Address - State:AR
Mailing Address - Zip Code:72113-7025
Mailing Address - Country:US
Mailing Address - Phone:501-851-2382
Mailing Address - Fax:501-803-4620
Practice Address - Street 1:14309 CANTRELL RD
Practice Address - Street 2:SUITE 7
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72223-4217
Practice Address - Country:US
Practice Address - Phone:501-224-6727
Practice Address - Fax:501-224-0374
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2007-10-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ARC7704207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARE58386Medicare UPIN