Provider Demographics
NPI:1114558491
Name:HORTON, COLBY RHEL (PA-C)
Entity Type:Individual
Prefix:
First Name:COLBY
Middle Name:RHEL
Last Name:HORTON
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 MEMORY LN
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-2231
Mailing Address - Country:US
Mailing Address - Phone:717-851-6454
Mailing Address - Fax:717-851-1665
Practice Address - Street 1:25 MONUMENT RD STE 145
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-5060
Practice Address - Country:US
Practice Address - Phone:717-851-6454
Practice Address - Fax:717-851-1665
Is Sole Proprietor?:No
Enumeration Date:2020-01-27
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC00077432086S0129X
363AS0400X
PAMH6959160363AS0400X
PAMA062554363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery