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General NPI Number Information
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NPI Number | 1639132418
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Entity Type | Individual
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Provider Name | DUANE A HOUGENDOBLER MD
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Gender | Male
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Dates
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Enumeration Date | 04/11/2006
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Last Update Date | 04/12/2023
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Provider Practice Location Address
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Address Line | 2003 STULTS ROAD SUITE 105
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City | HUNTINGTON
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State | IN
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Zip | 46750-1291
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Country | US
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Telephone | 260-355-3250
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Fax | 260-355-3259
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Provider Business Mailing Address
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Address Line | 11109 PARKVIEW PLAZA DR # 117
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City | FORT WAYNE
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State | IN
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Zip | 46845-1701
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 01031511A
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License Number State | IN
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