Provider Demographics
NPI:1265750434
Name:HOUGH-TELFORD, CATHERINE MARIE (MD)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:MARIE
Last Name:HOUGH-TELFORD
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 1:4033 TAMPA RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:OLDSMAR
Mailing Address - State:FL
Mailing Address - Zip Code:34677-3224
Mailing Address - Country:US
Mailing Address - Phone:813-854-2003
Mailing Address - Fax:813-855-2367
Practice Address - Street 1:3222 W AZEELE ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-3280
Practice Address - Country:US
Practice Address - Phone:813-872-8491
Practice Address - Fax:813-872-7766
Is Sole Proprietor?:No
Enumeration Date:2010-05-12
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.31260207P00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL175035Medicaid
AL174865Medicaid
AL511-64571OtherBCBS
AL511-64698OtherBCBS