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General NPI Number Information
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NPI Number | 1235253923
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Entity Type | Organization
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Legal Business Name | VICTOR L HORSLEY DPM LLC
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 12/30/2008
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Provider Practice Location Address
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Address Line | 4901 WEST MAIN
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City | BELLEVILLE
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State | IL
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Zip | 62226-4724
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Country | US
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Telephone | 618-222-1986
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Fax | 618-222-1898
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Provider Business Mailing Address
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Address Line | 4901 WEST MAIN
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City | BELLEVILLE
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State | IL
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Zip | 62226-4724
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Country | US
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Telephone | 618-222-1986
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Fax | 618-222-1898
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Authorized Official
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Title or Position | OWNER
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Name | VICTOR LEWIS HORSLEY
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Credential | DPM
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Telephone | 618-222-6866
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 016.004072
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License Number State |
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