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General NPI Number Information
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NPI Number | 1104943489
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Entity Type | Organization
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Legal Business Name | VERN H HORTON MD PC
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 01/07/2008
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Provider Practice Location Address
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Address Line | 2827 FT MISSOULA RD
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City | MISSOULA
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State | MT
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Zip | 59804
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Country | US
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Telephone | 406-728-4100
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Fax | 406-327-4502
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Provider Business Mailing Address
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Address Line | 5750 COCHISE DRIVE
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City | MISSOULA
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State | MT
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Zip | 59804-9746
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Country | US
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Telephone | 406-251-2160
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Fax | 406-251-2160
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Authorized Official
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Title or Position | OFFICE MANAGER CORP SECRETARY
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Name | MRS. SUZANNE BALL HORTON
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Credential |
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Telephone | 406-251-2160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 3719
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License Number State | MT
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