1225065451 NPI number — JOSEPH A HORTON MD

Table of content: JOSEPH A HORTON MD (NPI 1225065451)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225065451 NPI number — JOSEPH A HORTON MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HORTON
Provider First Name:
JOSEPH
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1225065451
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/03/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2000 BANEBERRY DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOOVER
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35244-6402
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-444-9648
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1214 COOLIDGE BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAFAYETTE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70503-2621
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
337-289-7991
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/26/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X , with the licence number:  22727 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 009986425 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 051534543 . This is a "BLUE CROSS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 009936933 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 010033CB65475 . This is a "SECTION 1011" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 300118893 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 00124500 . This is a "MISSISSIPPI MEDICAID" identifier , issued by the state of ( MS ) . This identifiers is of the category "OTHER".
  • Identifier: 051512023 . This is a "BLUE CROSS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 1451771 . This is a "EMERGENCY LA MEDICAID" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".
  • Identifier: 54854 . This is a "PTAN" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".
  • Identifier: 000021009 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 009975860 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 051505918 . This is a "BLUE CROSS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 051526884 . This is a "BLUE CROSS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 051505826 . This is a "BLUE CROSS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 051505918 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000021009 . This is a "BLUE CROSS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".




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