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General NPI Number Information
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NPI Number | 1700909678
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Entity Type | Organization
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Legal Business Name | LISA HORTON, M.D.,P.A.
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Dates
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Enumeration Date | 04/07/2007
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Last Update Date | 08/05/2011
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Provider Practice Location Address
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Address Line | 7310 RITCHIE HWY SUITE 516
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City | GLEN BURNIE
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State | MD
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Zip | 21061-3065
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Country | US
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Telephone | 410-761-7305
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Fax |
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Provider Business Mailing Address
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Address Line | 7310 RITCHIE HWY SUITE 516
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City | GLEN BURNIE
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State | MD
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Zip | 21061-3065
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Country | US
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Telephone | 410-761-7305
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LISA A HORTON
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Credential | M.D.
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Telephone | 410-761-7305
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | D31987
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License Number State | MD
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