MEDICARE: DR. MAURICE VINCENT HORTON DC

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	111N00000X	Chiropractor	1761	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

General Provider Information

NPI Number	:	1326040106
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MAURICE VINCENT HORTON DC

Provider Business Mailing Address
First Line	:	2307 N COLLEGE RD
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28405-6427
Country	:	US
Telephone Number	:	910-392-1488
Fax Number	:	910-392-1489

Provider Business Practice Location Address
First Line	:	2307 N COLLEGE RD
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28405-6427
Country	:	US
Telephone Number	:	910-392-1488
Fax Number	:	910-392-1489

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

Provider Enumeration Date	:	08/11/2005
Last Update Date	:	07/09/2007

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