Healthcare Provider Details

I. General information

NPI: 1346685765
Provider Name (Legal Business Name): HORIZONS DIAGNOSTICS, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2013
Last Update Date: 04/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2214 GATEWAY DR SUITE C
OPELIKA AL
36801-1500
US

IV. Provider business mailing address

106 ENTERPRISE CT SUITE C
COLUMBUS GA
31904-9227
US

V. Phone/Fax

Practice location:
  • Phone: 855-855-9533
  • Fax: 706-323-0245
Mailing address:
  • Phone: 706-321-0476
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number1300041381
License Number StateAL

VIII. Authorized Official

Name: BARBARA B BUTLER
Title or Position: CHIEF EXECUTIVE OFFICE
Credential: CEO
Phone: 706-321-0476