Horton, Russell
Horton, Russell is an sole proprietor health care provider with primary practice located at 21772 S Ellsworth Loop Rd , Queen Creek AZ 85142-7709. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Horton, Russell can be contacted via phone (480) 512-3700.Contact Information
Primary practice address
21772 S Ellsworth Loop Rd
Queen Creek AZ 85142-7709
Phone: (480) 512-3700
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | R1814 | Arizona |
Profile Details
| NPI number | 1780996967 |
|---|---|
| LBN Legal business name | Horton, Russell |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 5th, 2010 |
| Last updated | Jan 16th, 2014 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1780996967 | NPPES |
| Arizona | Other | R1814 | TRAINING PERMIT |
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