Healthcare Provider Details

I. General information

NPI: 1497065403
Provider Name (Legal Business Name): KAIRI L HORSLEY D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2010
Last Update Date: 07/31/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23077 GREENFIELD RD STE 255
SOUTHFIELD MI
48075-3750
US

IV. Provider business mailing address

23077 GREENFIELD RD STE 255
SOUTHFIELD MI
48075-3750
US

V. Phone/Fax

Practice location:
  • Phone: 248-559-5200
  • Fax: 248-599-6889
Mailing address:
  • Phone: 248-559-5200
  • Fax: 248-599-6889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number5901002371
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: