Organization
DAN HORTON, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STEPHANIE P. GREEN (OFFICE MANAGER)
(580) 353-3920
Entity
Organization
Contact information
Practice address
4417 W GORE BLVD, SUITE 6, LAWTON, OK 73505-5978
(580) 353-3920
(580) 353-3936
Mailing address
4417 W GORE BLVD, SUITE 6, LAWTON, OK 73505-5978
(580) 353-3920
(580) 353-3936
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
10253
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100089340A
—
OK
01
—
731026014-001
BCBS BILLING NUMBER
OK
Enumeration date
03/01/2007
Last updated
06/29/2010
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