Individual
DR. TIMOTHY C HOUGLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1445 CHRISTY DR STE A, JEFFERSON CITY, MO 65101-2853
(573) 659-5560
(573) 659-5561
Mailing address
1445 CHRISTY DR STE A, JEFFERSON CITY, MO 65101-2853
(573) 659-5560
(573) 659-5561
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2011018572
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12273374
CAQH
—
01
—
2011018572
LICENSE
MO
Enumeration date
06/03/2011
Last updated
08/23/2022
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