Provider Demographics
NPI:1144459249
Name:HOUK, JEFFREY (PA-C)
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:
Last Name:HOUK
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3428 BRODHEAD RD
Mailing Address - Street 2:
Mailing Address - City:MONACA
Mailing Address - State:PA
Mailing Address - Zip Code:15061-3132
Mailing Address - Country:US
Mailing Address - Phone:724-774-7756
Mailing Address - Fax:724-774-7874
Practice Address - Street 1:3428 BRODHEAD RD
Practice Address - Street 2:
Practice Address - City:MONACA
Practice Address - State:PA
Practice Address - Zip Code:15061-3132
Practice Address - Country:US
Practice Address - Phone:724-774-7756
Practice Address - Fax:724-774-7874
Is Sole Proprietor?:No
Enumeration Date:2009-07-09
Last Update Date:2009-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA001121L363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant