MEDICARE: LAUREN K. HORTON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	207R00000X	Internal Medicine Physician	0101249572	VA
3	207R00000X	Internal Medicine Physician	2013-02239	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205096948
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN K. HORTON MD

Provider Business Mailing Address
First Line	:	PO BOX 602484
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28260-2484
Country	:	US
Telephone Number	:	704-512-4808
Fax Number	:	704-512-4838

Provider Business Practice Location Address
First Line	:	1333 S DICKINSON DR
Second Line	:	SUITE 240
City	:	LELAND
State	:	NC
Zip	:	28451-6430
Country	:	US
Telephone Number	:	704-512-4808
Fax Number	:	704-512-4838

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2008
Last Update Date	:	10/06/2015

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Directions to “ LAUREN K. HORTON MD” Practice Location

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