Provider Demographics
NPI:1215993332
Name:HOUGHTON, RODNEY A (MD)
Entity type:Individual
Prefix:
First Name:RODNEY
Middle Name:A
Last Name:HOUGHTON
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 1:403 N STATE OF FRANKLIN RD
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-6034
Mailing Address - Country:US
Mailing Address - Phone:423-431-7013
Mailing Address - Fax:423-431-7130
Practice Address - Street 1:403 N STATE OF FRANKLIN RD
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-6034
Practice Address - Country:US
Practice Address - Phone:423-431-7013
Practice Address - Fax:423-431-7130
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD301062084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNTN01V3OtherJOHN DEERE
NE4106726OtherBCBS
TN3869920Medicaid
TN3869920Medicaid
TN3869920Medicare ID - Type Unspecified