Provider Demographics
NPI:1215987151
Name:HOUGH, JEFFREY L (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:L
Last Name:HOUGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2411 MANNING ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-5525
Mailing Address - Country:US
Mailing Address - Phone:215-732-2586
Mailing Address - Fax:
Practice Address - Street 1:1301 POWELL ST
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19401-3323
Practice Address - Country:US
Practice Address - Phone:610-270-2260
Practice Address - Fax:610-270-2362
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD021720E2085B0100X, 2085N0700X, 2085R0202X, 2085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA350726OtherPHCS
PA0057485000OtherAMERIHEALTH/INTERCOUNTY
PA0080920601OtherAMERICHOICE (UHC)
PA300040391OtherRRM
PA413486OtherHIGHMARK BLUE SHIELD
PA4388953OtherAETNA PPO
PA0008092060001Medicaid
PA2650607OtherAETNA HMO
PA0057485000OtherIBC - PC/KHPE
PA5654089OtherCIGNA HMO/PPO
PA0080920601OtherAMERICHOICE (UHC)
PA4388953OtherAETNA PPO