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Individual

DR. CHARLES R. HORTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
207 CARTER ST, BERRYVILLE, AR 72616-4303
(870) 423-6661
(870) 423-4374
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
(417) 829-4316

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R2H10
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
111358001
AR
05
202463923
MO
01
206337
HEALTHLINK PROV. #
MO
01
52481
AR BLUE SHIELD #
AR
Enumeration date
10/14/2006
Last updated
07/09/2007
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