Provider Demographics
NPI:1093750143
Name:HORVATH, MATTHEW THOMAS (DO)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:THOMAS
Last Name:HORVATH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1251 334TH ST
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:IA
Mailing Address - Zip Code:50276
Mailing Address - Country:US
Mailing Address - Phone:515-438-3251
Mailing Address - Fax:515-438-3631
Practice Address - Street 1:1251 334TH ST
Practice Address - Street 2:
Practice Address - City:WOODWARD
Practice Address - State:IA
Practice Address - Zip Code:50276
Practice Address - Country:US
Practice Address - Phone:515-438-3251
Practice Address - Fax:515-438-3631
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA029852084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0437509Medicaid
IA0437509Medicaid
IAI12587Medicare ID - Type Unspecified