Provider Demographics
NPI:1699737577
Name:HOURIGAN, PHILIP ANTHONY JR (MD)
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:ANTHONY
Last Name:HOURIGAN
Suffix:JR
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 1:907 SUMNER ST
Mailing Address - Street 2:SUITE M-102
Mailing Address - City:STOUGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02072-3374
Mailing Address - Country:US
Mailing Address - Phone:781-344-3791
Mailing Address - Fax:781-341-3614
Practice Address - Street 1:907 SUMNER ST
Practice Address - Street 2:SUITE M-102
Practice Address - City:STOUGHTON
Practice Address - State:MA
Practice Address - Zip Code:02072-3374
Practice Address - Country:US
Practice Address - Phone:781-344-3791
Practice Address - Fax:781-341-3614
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA36824208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2029081Medicaid
MA2029081Medicaid