Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0120X | Pediatric Surgery | 036-131051 | IL |
N | 2086S0120X | Pediatric Surgery | 60295888 | WA |
N | 2086S0120X | Pediatric Surgery | MD160235 | OR |
Y | 2086S0120X | Pediatric Surgery | MD452461 | PA |
NPI | 1487690889 |
---|---|
Provider Name | Dr. John Daniel Horton |
First Address | Gig Harbor, WA 98335-5632 |
Second Address | Tacoma, WA 98431-2170 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2006 |
Last Update Date | 09/01/2022 |