Organization
RAINSVILLE FAMILY PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS LEON HORTON MD (OWNER)
(256) 845-1401
Entity
Organization
Contact information
Practice address
421 MEDICAL CENTER DR SW, FORT PAYNE, AL 35968-3421
(256) 845-1401
(256) 845-1402
Mailing address
421 MEDICAL CENTER DR SW, FORT PAYNE, AL 35968-3421
(256) 845-1401
(256) 845-1402
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
13953
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
142769
—
AL
01
—
4221491
BLUE CROSS BLUE SHIELD OF TENNESSEE
TN
01
—
51107803
BCBS OF AL
AL
01
—
P00664321
RR MEDICARE
—
Enumeration date
08/26/2008
Last updated
01/24/2013
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