Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 35051737H | OH |
NPI | 1033219365 |
---|---|
Provider Name | Dr. Kevin A. Horvath |
First Address | Tipp City, OH 45371 |
Second Address | Tipp City, OH 45371 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0588958 | (05) | OH |