Individual
ALISA C HORSFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6335 HOSPITAL PKWY, SUITE 313, JOHNS CREEK, GA 30097-1549
(770) 979-9996
(770) 979-1202
Mailing address
PO BOX 3559, SUWANEE, GA 30024-0993
(770) 979-9996
(770) 979-1202
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
063242
GA
207L00000X
Anesthesiology Physician
D0069966
MD
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
63242
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
063242
LICENSE
GA
05
—
418741500
—
MD
01
—
D0069966
MARYLAND LICENSE
MD
Enumeration date
02/08/2007
Last updated
03/14/2012
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