MEDICARE: HORIZON INTERVENTIONAL PAIN PHYSICIANS, SC

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	207LP2900X	Pain Medicine (Anesthesiology) Physician

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	:	1861688418
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HORIZON INTERVENTIONAL PAIN PHYSICIANS, SC

Provider Business Mailing Address
First Line	:	7071 S 13TH ST
Second Line	:	SUITE 102
City	:	OAK CREEK
State	:	WI
Zip	:	53154-1466
Country	:	US
Telephone Number	:	414-600-1134
Fax Number	:	414-455-4494

Provider Business Practice Location Address
First Line	:	7071 S 13TH ST
Second Line	:	SUITE # 102
City	:	OAK CREEK
State	:	WI
Zip	:	53154-1466
Country	:	US
Telephone Number	:	414-600-1134
Fax Number	:	414-455-4494

Authorized Official
Title or Position	:	OWNER
Name	:	SALEEM A AWAN
Credential	:	MD
Telephone Number	:	414-600-1134

Provider Enumeration Date	:	09/18/2007
Last Update Date	:	06/08/2015

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