Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 36946 | MO |
NPI | 1578576864 |
---|---|
Provider Name | Dr. Stanley R. Horner |
First Address | Oskaloosa, IA 52577-4246 |
Second Address | Oskaloosa, IA 52577-4246 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2006 |
Last Update Date | 05/02/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F44527 | (02) | MO |