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General NPI Number Information
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NPI Number | 1700905619
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Entity Type | Individual
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Provider Name | ANTHONY R HORSTMAN O.D.
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Gender | Male
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 05/29/2009
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Provider Practice Location Address
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Address Line | 80 BAYLOR DR SUITE 104
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City | BLUFFTON
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State | SC
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Zip | 29910-8900
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Country | US
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Telephone | 843-706-3022
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Fax | 843-706-3027
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Provider Business Mailing Address
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Address Line | 20 BEAR ISLAND RD
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City | HILTON HEAD ISLAND
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State | SC
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Zip | 29926-1955
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Country | US
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Telephone | 843-341-6688
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1305
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License Number State | SC
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