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Individual

DR. JIMMIE ROGERS HORTON JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1350 DES MOINES ST, SUITE 110, DES MOINES, IA 50309-5507
(515) 643-0833
(515) 643-0933
Mailing address
PO BOX 1475, DES MOINES, IA 50305-1475
(515) 643-0833
(515) 643-0933

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
40546
IA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1710114434
IA
Enumeration date
06/20/2009
Last updated
02/24/2014
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