Provider Demographics
NPI:1811957343
Name:HOUGLAN, TODD DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:TODD
Middle Name:DAVID
Last Name:HOUGLAN
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 1:9044 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:SEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44273-8854
Mailing Address - Country:US
Mailing Address - Phone:330-769-2941
Mailing Address - Fax:330-769-4804
Practice Address - Street 1:9044 CENTER ST
Practice Address - Street 2:
Practice Address - City:SEVILLE
Practice Address - State:OH
Practice Address - Zip Code:44273-8854
Practice Address - Country:US
Practice Address - Phone:330-769-2941
Practice Address - Fax:330-769-4804
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35079612207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2268844Medicaid
OH2268844Medicaid
OHH36537Medicare UPIN