Basic Information
| Provider Information | |||||||||
| NPI: | 1528028610 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOUDE | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | P | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10 ALICE PECK DAY DR | ||||||||
| Address2: | |||||||||
| City: | LEBANON | ||||||||
| State: | NH | ||||||||
| PostalCode: | 037662694 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6034483121 | ||||||||
| FaxNumber: | 6034487462 | ||||||||
| Practice Location | |||||||||
| Address1: | 10 ALICE PECK DAY DR | ||||||||
| Address2: | |||||||||
| City: | LEBANON | ||||||||
| State: | NH | ||||||||
| PostalCode: | 037662900 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6034425630 | ||||||||
| FaxNumber: | 6034467469 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/24/2006 | ||||||||
| LastUpdateDate: | 03/29/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/29/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 0420010413 | VT | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207X00000X | 11504 | NH | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | F75854 | 01 | NH | HARVARD PILGRIM | OTHER | 602933 | 01 | VT | MVP | OTHER | 01Y004009NH01 | 01 | NH | ANTHEM BC/BS OF NEW HAMPSHIRE | OTHER | 1387569 | 01 | NH | CIGNA HEALTHCARE | OTHER | 30203221 | 05 | NH | MEDICAID | 1009003 | 05 | VT | MEDICAID | 421539118 | 01 | NH | UNITED HEALTHCARE | OTHER | 58952 | 01 | VT | BCVT | OTHER | 2972483 | 01 | NH | AETNA | OTHER |