=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598800179
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JOHN P. HOUDE, M.D. P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/21/2007
-----------------------------------------------------
Last Update Date | 11/07/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 241 ELM STREET
-----------------------------------------------------
City | CLAREMONT
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03743
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 603-542-7666
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 241 ELM STREET
-----------------------------------------------------
City | CLAREMONT
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03743
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 603-542-7666
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. JOHN P HOUDE
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 603-542-7666
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207X00000X
-----------------------------------------------------
Taxonomy Name | Orthopaedic Surgery Physician
-----------------------------------------------------
License Number | 0420010413
-----------------------------------------------------
License Number State | VT
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363A00000X
-----------------------------------------------------
Taxonomy Name | Physician Assistant
-----------------------------------------------------
License Number | 0486P
-----------------------------------------------------
License Number State | NH
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 363A00000X
-----------------------------------------------------
Taxonomy Name | Physician Assistant
-----------------------------------------------------
License Number | 0550030669
-----------------------------------------------------
License Number State | VT
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 207X00000X
-----------------------------------------------------
Taxonomy Name | Orthopaedic Surgery Physician
-----------------------------------------------------
License Number | 11504
-----------------------------------------------------
License Number State | NH
-----------------------------------------------------