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General NPI Number Information
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NPI Number | 1164461943
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Entity Type | Organization
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Legal Business Name | HORIZON MEDICAL PC
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Dates
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Enumeration Date | 06/06/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 600 PARK AVE
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City | GRAND HAVEN
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State | MI
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Zip | 49417-2173
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Country | US
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Telephone | 616-846-9712
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Fax | 616-846-9714
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Provider Business Mailing Address
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Address Line | 600 PARK AVE
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City | GRAND HAVEN
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State | MI
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Zip | 49417-2173
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Country | US
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Telephone | 616-846-9712
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Fax | 616-846-9714
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID T OTTENBAKER
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Credential | M.D.
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Telephone | 616-846-8540
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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