Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | MD2011-0001 | NM |
Y | 208600000X | Surgeon | MD2011-0001 | NM |
N | 2082S0105X | Plastic Hand Surgeon | MD2011-0001 | NM |
NPI | 1922202878 |
---|---|
Provider Name | Jeffrey B. Horton |
First Address | Henderson, NV 89044-0112 |
Second Address | Henderson, NV 89044-0112 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2007 |
Last Update Date | 24/05/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
BP1-0026527 | INSTITUTIONAL PERMIT (01) |