MEDICARE: PHILIP ANDREW HORTON M.D.

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	2084P0800X	Psychiatry Physician	034081	GA

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	:	1750366266
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHILIP ANDREW HORTON M.D.

Provider Business Mailing Address
First Line	:	300 HOSPITAL ROAD
Second Line	:	DWIGHT D. EISENHOWER MEDICAL CENTER - 12F
City	:	FORT GORDON
State	:	GA
Zip	:	30905-5650
Country	:	US
Telephone Number	:	706-432-3837
Fax Number	:	706-432-3780

Provider Business Practice Location Address
First Line	:	300 HOSPITAL ROAD
Second Line	:	DWIGHT D. EISENHOWER MEDICAL CENTER - 12F
City	:	FORT GORDON
State	:	GA
Zip	:	30905-5650
Country	:	US
Telephone Number	:	706-787-8290
Fax Number	:	706-787-0105

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

Provider Enumeration Date	:	12/08/2005
Last Update Date	:	11/14/2013

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