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NPI Code Detail

MEDICARE: ANNAH C HOUK PA-C

MEDICARE: ANNAH C HOUK PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician Assistant7533GA
2363A00000XPhysician Assistant1879-023WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1902878242
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNAH C HOUK PA-C
Provider Business Mailing Address
First Line : 6901 W EDGERTON AVE
Second Line :
City : GREENFIELD
State : WI
Zip : 53220-4420
Country : US
Telephone Number : 414-421-8400
Fax Number :
Provider Business Practice Location Address
First Line : 6901 W EDGERTON AVE
Second Line :
City : GREENFIELD
State : WI
Zip : 53220-4420
Country : US
Telephone Number : 414-421-8400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2006
Last Update Date : 01/12/2018

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Directions to “ ANNAH C HOUK PA-C” Practice Location

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