Provider Demographics
NPI:1811010531
Name:HOURIGAN, JON STUART (MD)
Entity type:Individual
Prefix:DR
First Name:JON
Middle Name:STUART
Last Name:HOURIGAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:800 ROSE STREET, DEPARTMENT OF SURGERY
Mailing Address - Street 2:ROOM C225
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0293
Mailing Address - Country:US
Mailing Address - Phone:859-323-6346
Mailing Address - Fax:859-323-6840
Practice Address - Street 1:800 ROSE STREET, DEPARTMENT OF SURGERY
Practice Address - Street 2:ROOM C225
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0293
Practice Address - Country:US
Practice Address - Phone:859-323-6346
Practice Address - Fax:859-323-6840
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2018-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY41488208600000X, 208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100012110Medicaid