Provider Demographics
NPI:1164407326
Name:HORTON, JAMES GLENN (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:GLENN
Last Name:HORTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:13000 N MERIDIAN ST STE 101
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-1404
Mailing Address - Country:US
Mailing Address - Phone:317-848-1402
Mailing Address - Fax:317-575-6912
Practice Address - Street 1:13000 N MERIDIAN ST STE 101
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-1404
Practice Address - Country:US
Practice Address - Phone:178-481-4023
Practice Address - Fax:317-575-6912
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2022-12-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI50704207Q00000X
TXH0464207Q00000X
IN01081741A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX121534506Medicaid
A98552Medicare UPIN