Provider Demographics
NPI:1174559736
Name:HOUGH, TOBI M (MD)
Entity type:Individual
Prefix:
First Name:TOBI
Middle Name:M
Last Name:HOUGH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8111 TOWNSHIP LINE RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-2479
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8111 TOWNSHIP LINE RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-2479
Practice Address - Country:US
Practice Address - Phone:317-415-8111
Practice Address - Fax:317-575-7333
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01054049A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000186958OtherANTHEM BCBS
160052557OtherMEDICARE RAILROAD
7365233OtherAETNA
1148065OtherPASSPORT KY MEDICAID
IN200329930AMedicaid
IN419313POtherSIHO
KY2438419000OtherPASSPORT ADVANTAGE
IN419313POtherSIHO
1148065OtherPASSPORT KY MEDICAID
160052557OtherMEDICARE RAILROAD
KY64034234Medicaid
IN412840GGMedicare PIN