Healthcare Provider Details

I. General information

NPI: 1518152172
Provider Name (Legal Business Name): FREDERICK WILLIAM HOUTS M.D., M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2007
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 4TH ST NW
FARIBAULT MN
55021-5089
US

IV. Provider business mailing address

400 4TH ST NW
FARIBAULT MN
55021-5089
US

V. Phone/Fax

Practice location:
  • Phone: 507-384-6830
  • Fax: 651-431-7757
Mailing address:
  • Phone: 507-384-6830
  • Fax: 651-431-7757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number61077
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number7312
License Number StateAK
# 3
Primary TaxonomyN
Taxonomy Code2084F0202X
TaxonomyForensic Psychiatry Physician
License Number7312
License Number StateAK
# 4
Primary TaxonomyN
Taxonomy Code2084F0202X
TaxonomyForensic Psychiatry Physician
License Number61007
License Number StateMN
# 5
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number7312
License Number StateAK
# 6
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number61007
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: