Basic Information
| Provider Information | |||||||||
| NPI: | 1194732586 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOUGH | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | C | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4401 N CAMPUS RIDGE DR | ||||||||
| Address2: | SUITE C2100 | ||||||||
| City: | MIDLAND | ||||||||
| State: | MI | ||||||||
| PostalCode: | 486406112 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9898379200 | ||||||||
| FaxNumber: | 9898379205 | ||||||||
| Practice Location | |||||||||
| Address1: | 4401 N CAMPUS RIDGE DR | ||||||||
| Address2: | SUITE C2100 | ||||||||
| City: | MIDLAND | ||||||||
| State: | MI | ||||||||
| PostalCode: | 486406112 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9898379200 | ||||||||
| FaxNumber: | 9898379205 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/01/2006 | ||||||||
| LastUpdateDate: | 09/14/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | JH042855 | MI | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.