Provider Demographics
NPI:1073642880
Name:HORSLEY, JAMES IRWIN (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:IRWIN
Last Name:HORSLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 UCHEE PINES RD LOT 75
Mailing Address - Street 2:
Mailing Address - City:SEALE
Mailing Address - State:AL
Mailing Address - Zip Code:36875-5726
Mailing Address - Country:US
Mailing Address - Phone:334-855-4764
Mailing Address - Fax:334-855-9014
Practice Address - Street 1:30 UCHEE PINES RD LOT 75
Practice Address - Street 2:
Practice Address - City:SEALE
Practice Address - State:AL
Practice Address - Zip Code:36875-5726
Practice Address - Country:US
Practice Address - Phone:334-855-4764
Practice Address - Fax:334-855-9014
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA025873208D00000X
AL00019762208D00000X
KY39752208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100393140Medicaid
KY7100393140Medicaid
KYK199940Medicare PIN
GA25BDBLBMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
ALE83701Medicare UPIN