MEDICARE: DR. BRIAN DAVID HOROWITZ DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	DPM269	TN
2	213E00000X	Podiatrist	236	AR

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00381696	OTHER	AR	MEDICARE ID TYPE UNSPECIFIED

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336162221
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN DAVID HOROWITZ DPM

Provider Business Mailing Address
First Line	:	401 GRAHAM ST
Second Line	:
City	:	WEST MEMPHIS
State	:	AR
Zip	:	72301-3117
Country	:	US
Telephone Number	:	870-735-6500
Fax Number	:	870-735-4442

Provider Business Practice Location Address
First Line	:	401 GRAHAM ST
Second Line	:
City	:	WEST MEMPHIS
State	:	AR
Zip	:	72301-3117
Country	:	US
Telephone Number	:	870-735-6500
Fax Number	:	870-735-4442

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	04/28/2016

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