Provider Demographics
NPI:1043284599
Name:HORTON, CHRISTY A (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTY
Middle Name:A
Last Name:HORTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 9TH ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:OR
Mailing Address - Zip Code:97439-7398
Mailing Address - Country:US
Mailing Address - Phone:541-997-8412
Mailing Address - Fax:541-902-7502
Practice Address - Street 1:400 9TH ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:OR
Practice Address - Zip Code:97439-7398
Practice Address - Country:US
Practice Address - Phone:541-997-8412
Practice Address - Fax:541-902-7502
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD25486207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR275278Medicaid
ORRR PTAN P0031540Medicare PIN
ORR146380Medicare PIN
OR275278Medicaid
ORR133434Medicare PIN