Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 04-23876 | KS |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 04-23876 | KS |
N | 207XX0801X | Orthopaedic Trauma Surgeon | 04-23876 | KS |
NPI | 1396854303 |
---|---|
Provider Name | Greg A Horton |
First Address | Kansas City, KS 66103-2937 |
Second Address | Kansas City, KS 66160 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 22/06/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100173860A | (05) | KS |
200023632 | RAILROAD MEDICARE (01) | |
207920604 | (05) | MO |
21962042 | BCBS (01) | MO |
626100 | FIRSTGUARD (01) | KS |
G03775 | (02) |