Individual
MITCHELL F HORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6000 KANAKANK, DILLINGHAM, AK 99576-0130
(907) 842-9217
(907) 842-9250
Mailing address
PO BOX 130, DILLINGHAM, AK 99576-0130
(907) 842-9217
(907) 842-9250
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
32379
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007999
—
AK
05
—
851239
—
AZ
01
—
8EE795
MEDICARE PTAN
TX
Enumeration date
12/27/2005
Last updated
04/26/2021
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